Traumatic dislocation of the hip with separation of the capital epiphysis: 5 adolescent patients with 3 9 years of follow-

Odent, Thierry; Glorion, Christophe; Pannier, Stéphanie; Bronfen, C.; Langlais, Jean; Jc, Pouliquen

doi:10.1080/00016470310013653

Cited by 33 publications

(9 citation statements)

References 11 publications

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“…With epiphysiolysis, the rate of FHO is near 100% (Figure 1). 17,18 While there is less literature on FHO following traumatic hip dislocation, Mehlman et al 15 reported on a series of 42 traumatic hip dislocations in children with a 12% rate of subsequent FHO.…”

Section: Key Conceptsmentioning

confidence: 99%

Pediatric Femoral Head Osteonecrosis Secondary to Trauma, Sickle Cell Disease, and Corticosteroid Therapy

Kim¹,

Morris²

2021

Journal of the Pediatric Orthopaedic Society of North America

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Management of pediatric femoral head osteonecrosis (FHO) due to various etiologies remains a clinical challenge due to delayed diagnosis, limited evidence to guide treatment decision making, and a lack of consensus on treatments to prevent the femoral head deformity. Since many review articles have been written on Legg-Calve-Perthes disease, this review focuses on pediatric FHO secondary to trauma, sickle cell disease, and corticosteroid therapy. Post-Traumatic FHO is a serious complication that can occur following femoral neck fractures and traumatic hip dislocations in children. Sickle cell disease is the most common inherited blood disorder in the US and is a common cause of multi-focal osteonecrosis in patients of African descent and from the sub-Saharan Africa, the Mediterranean, the Persian Gulf, and the Indian subcontinent. Corticosteroid induced osteonecrosis in patients with acute lymphocytic leukemia is of particular interest since acute lymphocytic leukemia is prevalent in the pediatric population. The goal of this review is to educate the clinician on the epidemiology, pathophysiology, natural history, evaluation, and treatment considerations for pediatric FHO secondary to these conditions.

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Section: Key Conceptsmentioning

confidence: 99%

Pediatric Femoral Head Osteonecrosis Secondary to Trauma, Sickle Cell Disease, and Corticosteroid Therapy

Kim¹,

Morris²

2021

Journal of the Pediatric Orthopaedic Society of North America

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“…The rate of AVN in these patients approaches 100%. Epiphysiolysis has been reported both at the time of injury, 3,5,18 and also as a complication of attempted reduction. 4,5,7 Most of the patients in these series had posterior dislocations.…”

Section: Coronal Ct Slice Demonstrating the Intrapelvic Femoral Headmentioning

confidence: 99%

“…Epiphysiolysis has been reported both at the time of injury, 3,5,18 and also as a complication of attempted reduction. 4,5,7 Most of the patients in these series had posterior dislocations. None had an obturator dislocation, as we describe in the patient presented here.…”

Section: Coronal Ct Slice Demonstrating the Intrapelvic Femoral Headmentioning

confidence: 99%

“…2 Pediatric hip dislocations with concurrent proximal femoral physeal injuries are associated with severe trauma and a poor prognosis with high rates of complications, including AVN, premature physeal arrest, and nonunion. [3][4][5][6] In 2016, Kennon et al published a series of 12 patients who had hip dislocations associated with proximal femoral physeal fractures or epiphysiolysis, 11 of whom developed ischemic necrosis of the femoral head. 3 Herrera-Soto et al in 2006, described a series of five patients who underwent closed reductions of posterior hip dislocations and who suffered iatrogenic epiphysiolysis of the femoral head during reduction.…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Physeal Separation During Attempted Reduction of an Obturator Hip Dislocation

Myhre¹,

Jones

Duensing

et al. 2020

Journal of the Pediatric Orthopaedic Society of North America

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Obturator hip dislocations are exceedingly rare, comprising <5% of hip dislocations1, with an even smaller percentage of these dislocations involving penetration of the obturator foramen with an irreducible intrapelvic femoral head. There are no reports of this in the pediatric population. We report a case of a 16 year old male who presented with a trans obturator hip dislocation which was irreducible by closed means and underwent open reduction. The open reduction was complicated by intraoperative acute physeal separation, also known as epiphysiolysis. This was managed with reduction of the epiphysis and fixation with a fully threaded screw, followed by reduction and capsular repair. The combination of this injury and subsequent complication has not been previously reported in the literature. Our report and focused review of the relevant literature should guide clinicians who encounter a similar clinical scenario.

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“…4 Complications include avascular necrosis (AVN), coxa vara, leg length discrepancy, premature epiphyseal closure, 5,6 and associated angular deformity. 7 The rarest hip fracture type in children is a type I fracture with or without dislocation, 8 based on the Delbet and Colonna 9 classification. If AVN develops, there is no consensus on effective treatment aside from prolonged non-weight bearing.…”

Section: Introductionmentioning

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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Traumatic dislocation of the hip with separation of the capital epiphysis: 5 adolescent patients with 3 9 years of follow-

Cited by 33 publications

References 11 publications

Pediatric Femoral Head Osteonecrosis Secondary to Trauma, Sickle Cell Disease, and Corticosteroid Therapy

Pediatric Femoral Head Osteonecrosis Secondary to Trauma, Sickle Cell Disease, and Corticosteroid Therapy

Iatrogenic Physeal Separation During Attempted Reduction of an Obturator Hip Dislocation

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

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