Septic physeal separation of proximal femur in a newborn

Abstract

In newborns physeal separations and septic osteomyelitis or arthritis are unusual, representing a problem in diagnosis and treatment. Therapy needs to be carried out soon in order to prevent anatomical and functional consequences. Association between septic event and physeal separation is rare. We report a 28-day-old female, admitted for elevated temperature, who underwent three nonorthopaedic surgical procedures before, and orthopaedic evaluation 8 days after admission. After an X-ray and an ultrasonography a septic arthritis with consequent hip dislocation was supposed. Only at the time of surgery a separation between the epiphysio-trochanteric nuclei complex and the femoral shaft was observed, with clear hip joint. The interest in this case consists in the difficulty of the differential diagnosis at the first evaluation, the orthopaedic misdiagnosis based on the lack of complete preoperative imaging, and finally the long-term excellent result after a prompt surgical treatment.

Physeal separation and complete resorption of femoral head associated with chronic osteomyelitis of femoral diaphysis in a young child: rare case report

“…However, after a thorough literature review, we did not find any report of complete femoral head resorption in a young child as reported by us. Partial or complete slip of the proximal femoral epiphysis has been reported to be a complication of hip infection, whereas to the best of our knowledge, complete separation of the epiphysiotrochanteric nuclei complex has only been described a few times [15,20] and in neonates rather than in young children.…”

Late-Presenting Septic Arthritis of the Hip in Children: Variations in Presentation and a Review of 25 Hips After Surgical Debridement

“…There have been reports of proximal femoral epiphyseal separations or septic slips after SAH in neonates and infants [22][23][24][25]. However, they are rare, especially in children older than two [23,26].…”

Akut osteomiyelitli bir yenidoğan olgusu

“…Akut osteomiyelit, yenidoğan döneminde ilk haftada nadir rastlanır, 25-30. günlerde pik yapar ve önemli morbidite ve mortalite nedenidir (1,2,3,4). Akut osteomiyelitin insidansı, hayatın ilk haftasında %0,1-0,3 olarak belirtilmiştir (4,5).…”