@article{ref1,
title="Bilateral distal humeral physeal separation-from birth trauma to family trauma",
journal="Journal of orthopaedic case reports",
year="2023",
author="Siddiqui, Yasir Salam and Abbas, Mohammad Baqar and Anwer, Adnan and Abbas, Mazhar and Chowdhry, Madhav and Khurana, Shivank",
volume="13",
number="9",
pages="88-92",
abstract="INTRODUCTION: Chondro-epiphyseal separation of the distal humerus is a rare injury, which can occur as a consequence of excessive traction on the upper extremity accompanying a dystocic birth or one complicated by cephalopelvic disproportion. Such fracture patterns can also result from a combination of rotatory and shear forces, also typically seen following child abuse. It can be easily mistaken for a posterior elbow dislocation, creating a delay in diagnosis. Since unossified cartilage cannot be seen radiographically, these injuries are better appreciated by ultrasound or magnetic resonance imaging. CASE REPORT: We present a case of an 8-day-old neonate who presented with pseudoparesis of the left arm following birth. Posterior displacement of the elbow joint was identified on the radiograph. On ultrasound, a trans-physical supracondylar distal humerus fracture was identified. This was presumed as trauma secondary to a difficult delivery. At the 11th week of follow-up, the patient presented with a fracture of the right proximal tibia, followed by a fracture shaft left femur at 5 months of follow-up. Chest X-ray at this time revealed uniting rib fractures with callus formation. After ruling out any congenital collagen disorder (osteogenesis imperfecta), the patient was diagnosed with a case of battered baby syndrome. The case was reported to child protection services and parents were questioned and counseled for the same. <br><br>CONCLUSION: This case report highlights the importance of a high degree of suspicion of child abuse in any child with a rare fracture pattern, uncommon serial fracture occurrence, and unconventional clinic-radiological presentation.<p /> <p>Language: en</p>",
language="en",
issn="2250-0685",
doi="10.13107/jocr.2023.v13.i09.3888",
url="http://dx.doi.org/10.13107/jocr.2023.v13.i09.3888"
}