Transepiphyseal Fracture of the Femoral Neck With Dislocation of the Femoral Head and Fracture of the Posterior Column of the Acetabulum in a Child

Mohammad, S.; Port, A.; Montgomery, R. J.

doi:10.1302/0301-620x.84b1.0840113

Cited by 11 publications

(3 citation statements)

References 17 publications

(21 reference statements)

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“…They generally occur as a result of high-energy trauma. These fractures peak particularly at two periods during childhood and from different causes: first, at a mean age of 7 years, from moderate-energy trauma of falling while participating in sports; and second, at ages 11–15 years, as a result of traffic accidents [6]. Factors that affect the prognosis include the type of trauma, type of fracture, and time to surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Transepiphyseal Seperation and Dislocation of the Femoral Head

Elmadağ

Ceylan²,

Erdem³

et al. 2013

Case Reports in Orthopedics

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Pediatric hip fractures and dislocations are rare in practice and are related to high-energy trauma. The incidence of postoperative avascular necrosis is increasing, especially in the case of transepiphyseal fractures. Surgery is the most common form of treatment, and its timing is important for prognosis of the fracture. Patients and their families should be informed about the possibility of avascular necrosis and further complications related to the fracture.

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Section: Discussionmentioning

confidence: 99%

Pediatric Transepiphyseal Seperation and Dislocation of the Femoral Head

Elmadağ

Ceylan²,

Erdem³

et al. 2013

Case Reports in Orthopedics

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“…However, in one describing separation of the capital femoral epiphysis featuring small posterior fragments of the epiphysis, the epiphysis remained at the joint cavity of the hip. 22 In addition, that case focused on an association with the posterior acetabular wall. The other case involved a fracture of the medial aspect of the femoral neck, which was considered to be a Salter-Harris II fracture fragment.…”

Section: Discussionmentioning

confidence: 99%

A Transepiphyseal Fracture of the Femoral Neck in a Child With 2 Widely Displaced Salter-Harris III Fragments of the Capital Femoral Epiphysis

Lee

Park

Lee

2010

Journal of Orthopaedic Trauma

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To our knowledge, this is the first report of a transphyseal fracture of the femoral neck with a fracture of the capital femoral epiphysis involving 2 widely displaced Salter-Harris III fragments in a child. Preoperative surgical lateral radiographs of the hip of a 14-year-old boy clearly showed an anteriorly dislocated femoral head fragment. However, the overlapping ischium, soft tissue, and an anteriorly dislocated femoral head fragment caused a posteriorly dislocated fragment of the split femoral head to be overlooked on the radiographs. The emergent nature of the injury resulted in the performance of an open reduction without further imaging studies. Based on the initial evaluation, an anterior iliofemoral approach was chosen, which made it difficult to locate the posteriorly dislocated main fragment of the split femoral head. This case highlights that plain radiographs do not always provide adequate information for such injuries. Computed tomography or magnetic resonance imaging should be employed to enable accurate diagnosis and appropriate treatment for fracture-dislocations of the pediatric hip.

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“…Delbet type Ia fractures are those in which the capital epiphysis remains within the acetabulum, while in type Ib fractures, the capital epiphysis is dislocated, with a reported AVN rate after reduction of 74% [ 8 ]. The reported incidence of AVN after a Delbet type I injury is 80-100% [ 9 ]. Most (75-92%) hip dislocations in adolescents are posterior [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Favorable Outcome Twenty-Two Months after Delbet Type Ib Capital Femoral Transepiphyseal Fracture and Posterior Column Acetabular Fracture in a Fifteen-Year-Old Male

Sethuraman

Morse

Guzman

et al. 2022

Case Reports in Orthopedics

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Case. A fifteen-year-old male patient sustained a posteriorly dislocated right capital femoral Delbet type Ib epiphyseal fracture-separation and a right acetabular posterior column fracture after a low-energy trip and fall. The capital femoral epiphysis was closed reduced and fixed with cannulated screws on an urgent basis. He underwent acetabular osteosynthesis via a Kocher-Langenbeck approach two days thereafter. Twenty-two months after injury, he was weight-bearing on the right lower extremity without radiologic evidence of avascular necrosis or clinical evidence of pain or functional deficit. Conclusion. Fracture-separation of the capital femoral epiphysis comprises only 8% of skeletally immature femoral neck fractures in the Delbet and Colonna classification. Prognosis is worse with ipsilateral hip dislocation due to the risk of avascular necrosis from disruption of the medial femoral circumflex artery. Urgent referral to a trauma center and treatment by appropriate specialists enables good long-term results after this uncommon traumatic injury pattern.

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Transepiphyseal Fracture of the Femoral Neck With Dislocation of the Femoral Head and Fracture of the Posterior Column of the Acetabulum in a Child

Cited by 11 publications

References 17 publications

Pediatric Transepiphyseal Seperation and Dislocation of the Femoral Head

Pediatric Transepiphyseal Seperation and Dislocation of the Femoral Head

A Transepiphyseal Fracture of the Femoral Neck in a Child With 2 Widely Displaced Salter-Harris III Fragments of the Capital Femoral Epiphysis

Favorable Outcome Twenty-Two Months after Delbet Type Ib Capital Femoral Transepiphyseal Fracture and Posterior Column Acetabular Fracture in a Fifteen-Year-Old Male

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