[Labor trauma-induced epiphysiolysis of the proximal femur. 4 cases].
The authors report on 4 cases of obstetrical traumatic slipping of the upper femoral epiphysis. Firstly, they emphasise the difficulties of diagnosis because trauma is often missed. In two cases the delivery was a cesarean section (in the same clinic!). Wrong diagnoses are: --neonatal septic arthritis with swelling and inflammation of the hip, lateral deviation of the metaphysis on the x-ray. Nevertheless, there are no signs of an infectious disease and symptoms begin at birth. --congenital dislocation of the hip but clinical testing of stability is painful and doubtful. Secondly, when diagnosis is uncertain, a joint aspiration confirms haemarthrosis, and arthrography shows the displacement of the epiphysis on the metaphysis. Finally, the authors explain their therapeutic procedure: three times orthopaedic treatment with traction and spica cast for 2 months, a pin osteosynthesis in one case. Prognosis was favourable in two cases, but the two other cases present a lateral rotation of the leg in relation to a retroversion of the femoral head.