Traumatic Separation of the Upper Femoral Epiphysis as an Obstetrical Lesion

Obstetrical fracture-separation of the upper femoral epiphysis

During the last 15 years we have treated six neonates with obstetrical fracture of the upper epiphysis of the femur. Two other cases have previously been reported by one of us (S.D.T.) in 1958. A common characteristic was a difficult and traumatic breech delivery, half the babies being "large-for-dates". The clinical and radiological signs of this injury are described. In two babies there were associated injuries of the same limb whilst two others had congenital dislocation of the contralateral hip. The prognosis appears to be excellent, in spite of the severity of the injury, and irrespective of treatment.

Birth injuries to the epiphyseal cartilage

A birth injury in the vicinity of a joint might lead to a fracture through the epiphyseal cartilage. The criteria for diagnosing such a fracture at radiography are considered and the continued remodelling of the bone demonstrated. The history of 2 cases with late diagnosis and serious long-term sequelae are described, in order to emphasize the necessity of early radiography.