Nine of 11 fractures were displaced and treated with open reduction and internal fixation. The other two had minimal loss of motion, and all had normal function and collateral ligament stability. The displacement and size of the epiphyseal fragment, avulsed and rotated by the collateral ligament, are often underestimated by radiographs. We found that anatomic reduction and fixation yielded good results in all displaced fractures. This restores both the stability of the collateral ligament and a smooth articular surface.
Statistics show that more than half the victims of child abuse have fractures.
The orthopedic surgeon will often be the first person to identify a potentially abused child. For protection of the child, it is essential that the orthopedic surgeon recognize the signs of child abuse and make a referral to the appropriate child protection agency. In this review article, we discuss recognition of common types of child abuse and outline appropriate management of child abuse cases.