Child abuse in infants with proximal physeal injuries of the femur.
OBJECTIVE
Child abuse has been recognized to be a common cause of femur fractures in infants. Fractures of the proximal femoral physis in abused infants have been less emphasized. Our report seeks to highlight this infrequent but clinically important inflicted injury.


METHODS
Report of 2 cases and a literature review of fractures of the proximal femoral physis in infants, including the role of abuse in this injury.


CONCLUSIONS
Proximal femoral physeal injuries occur infrequently in infants but often result from abuse. Diagnosis may be difficult due to lack of femoral head ossification before 4 months of age and clinical findings suggesting developmental dysplasia of the hip. Current imaging modalities can differentiate physeal injuries from developmental dysplasia of the hip. Early recognition and treatment can minimize sequelae.
Jones
Joshua C W
JCW
*General Pediatric Division, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA; †Department of Orthopedics, University of Washington School of Medicine, Seattle, WA; ‡Children's Hospital and Regional Medical Center, Seattle, WA.
Feldman
Kenneth W
KW
Bruckner
James D
JD
D000367:Age Factors; D002649:Child Abuse / Q000175:diagnosis*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D005269:Femur / Q000000981:diagnostic imaging / Q000293:injuries*; D005270:Femur Head / Q000000981:diagnostic imaging / Q000293:injuries; D005271:Femur Head Necrosis / Q000209:etiology; D005581:Foster Home Care; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006617:Hip Dislocation / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D006618:Hip Dislocation, Congenital / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging; D009357:Neonatal Abstinence Syndrome / Q000150:complications; D010012:Osteogenesis; D011859:Radiography; D000072042:Salter-Harris Fractures