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A Transphyseal Fracture of the Nonossified Proximal Femoral Epiphysis as a Result of Child AbuseA Case Report
Bayard C. Carlson, BA1; Walter O. Carlson, MD2; Keith M. Baumgarten, MD2
1 Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue, Chicago, IL 60611-3008
2 Orthopedic Institute, 810 East 23rd Street, Sioux Falls, SD 57108. E-mail address for K.M. Baumgarten: Kbaumgarten@ortho-i.com
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Investigation performed at the Orthopedic Institute, Sioux Falls, South Dakota

JBJS Case Connector, 2012 Aug 22;2(3):e42 1-5. doi: 10.2106/JBJS.CC.K.00171
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A transphyseal fracture of the hip is a rare injury in children1-6. Less than 1% of pediatric fractures involve fractures of the proximal part of the femur, and the frequency of such fractures in children is less than 1% of the frequency observed in adults3,7. Transphyseal fractures of the hip generally result from high-force trauma associated with falls, motor vehicle accidents, seizures, breech deliveries, and child abuse1,3,5,6,8-14, or from pathologic causes such as bone cysts or osteogenesis imperfecta12. A transphyseal fracture occurring prior to the ossification of the proximal femoral epiphysis, which typically occurs between the age of four to six months3, is even less common.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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