Traumatic separation of the upper femoral epiphysis in a neonate

BACKGROUND: Traumatic separation of the upper femoral epiphyses at birth is a rare event. Other terminologies that have been used to describe the injury include traumatic proximal femoral epiphysiolysis and apparent dislocation of the hip.This injury is associated with difficult deliveries. AIM: To report a case of traumatic separation of the upper femoral epiphysis in a neonate following a caesarean section. CASE REPORT: A full term infant female was delivered by breech extraction through a caesarean section in 2007. She weighed 4.2kg at birth and her mother was not a known diabetic. Her mother noticed she had reduced movement in her right lower extremity five days after delivery and this necessitated an orthopaedic consultation. After a clinical review a diagnosis of congenital dislocation of the right hip was made.An initial pelvic radiograph was taken and a repeat radiograph taken 3 weeks after delivery showed callus around the neck of the right femur.This indicated a healing traumatic separation of the right upper femoral epiphysis. CONCLUSION: Traumatic separation of the upper femoral epiphysis in the newborn is an uncommon injury. A high index of suspicion is required as the condition is easily misdiagnosed.