Child abuse in infants with proximal physeal injuries of the femur.

OBJECTIVE

Child abuse has been recognized to be a common cause of femur fractures in infants. Fractures of the proximal femoral physis in abused infants have been less emphasized. Our report seeks to highlight this infrequent but clinically important inflicted injury.

METHODS

Report of 2 cases and a literature review of fractures of the proximal femoral physis in infants, including the role of abuse in this injury.

CONCLUSION

Proximal femoral physeal injuries occur infrequently in infants but often result from abuse. Diagnosis may be difficult due to lack of femoral head ossification before 4 months of age and clinical findings suggesting developmental dysplasia of the hip. Current imaging modalities can differentiate physeal injuries from developmental dysplasia of the hip. Early recognition and treatment can minimize sequelae.