Epiphysiolysis with separation of the capital femoral epiphysis after reduction of traumatic dislocation of the hip–a case report

Abstract

Correspondence: Dr. Deepak Jain, 133, New Lajpat Nagar, Opp. Hotel Imperial, Pakhowal Road, Ludhiana, Punjab, India. E-mail: deepakjainorth@rediffmail.com posterior dislocation of the left hip. The hip was reduced in the emergency ward, 4 hours after the injury under conscious sedation without the need of any undue force. The post-reduction radiograph revealed separation of the capital femoral epiphysis that was laying dislocated (Figure 2). Open reduction and internal fixation with posterior approach using two 7 mm cancellous cannulated screws, was done within 6 hours of the injury (Figure 3). The epiphysis was found attached to the neck by a thin strip of periosteum, which was preserved. It was difficult to assess the exact reduction of the capital epiphysis on the neck, as there were no inter-digitating edges and due to the circular profile of the neck and the separated portion. It was also difficult to assess the exact alignment of the reduced fragment and the position of the cannulated screws in antero-posterior and lateral planes. This was because the patient was in a lateral position and proper positioning of the image intensifier was not possible before the reduction of the hip joint. The patient was discharged with skin traction for 2 weeks and non-weight bearing walking for next 4 weeks after which partial weight bearing was commenced. The patient had good hip function in the first 10 months post surgery. Epiphysiolysis with separation of the capital femoral epiphysis after reduction of traumatic dislocation of the hip—a case report