Complete distal humeral epiphyseal separation indicating a battered child syndrome: a case report.
BACKGROUND
Complete distal humeral epiphysiolysis is a rare and uncommon injury and may result from severe trauma, e.g. birth injury or battered child syndrome.


METHODS
This is a case report of a 5-month-old female child with distal humeral epiphysiolysis. In the course of clinical and radiological examinations, a battered child syndrome could be diagnosed. Open reduction and temporary transfixation of the distal humeral physis were performed. In the middle term follow-up, 1.5-years after the injury, the function of the elbow was nearly normal but the ulnar condyle showed growth disturbance with cubitus varus of 10 degrees.


CONCLUSIONS
Correct diagnosis of complete distal humeral epiphysiolysis may be difficult and misinterpretation of the injury as elbow dislocation should be avoided. This particular lesion is a strong indicator of child abuse. Treatment options and the necessity of operative procedures are discussed.
Hansen
Matthias
M
Clinic for Trauma-, Hand- and Reconstructive Surgery, City Hospital Worms, Gabriel-von-Seidl-Strasse 81, Worms, Germany. hansen-mainz@gmx.de
Weltzien
A
A
Blum
J
J
Botterill
N J
NJ
Rommens
P M
PM
D001497:Battered Child Syndrome / Q000175:diagnosis*; D001864:Bone Wires; D002370:Casts, Surgical; D003952:Diagnostic Imaging; D004838:Epiphyses / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006811:Humerus / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D007223:Infant