Spontaneous correction of angulational deformity of the proximal femoral epiphysis after cervical and trochanteric fracture.

This case report of a 5-year-old girl describes a severely comminuted fracture of the cervical and trochanteric areas of the left proximal femur which required open reduction and internal fixation for stable realignment. At 7 months follow-up, angulational deformity was recognized due to partial growth arrest leading to valgus tilt of the proximal femoral epiphysis. After persisting 1 year, gradual spontaneous improvement occurred leading to total realignment with a normally wide growth plate at 36 months following injury. It is hypothesized that the valgus deviation of the femoral head, by causing a medial shift of the weight bearing axis, led to relative unloading of the lateral margin of the growth plate. It is suggested that this mechanical element contributed to the spontaneous release of the epiphyseal tether.