TY  - JOUR
PY  - 2023//
TI  - Bilateral distal humeral physeal separation-from birth trauma to family trauma
JO  - Journal of orthopaedic case reports
A1  - Siddiqui, Yasir Salam
A1  - Abbas, Mohammad Baqar
A1  - Anwer, Adnan
A1  - Abbas, Mazhar
A1  - Chowdhry, Madhav
A1  - Khurana, Shivank
SP  - 88
EP  - 92
VL  - 13
IS  - 9
N2  - 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>
LA  - en
SN  - 2250-0685
UR  - http://dx.doi.org/10.13107/jocr.2023.v13.i09.3888
ID  - ref1
ER  -