31-E/1.1   Traumatic epiphysiolysis, SH I

This fracture is a traumatic separation of the proximal femoral epiphysis, caused by a high-energy trauma (eg, a fall from height).

These injuries carry a high risk of avascular necrosis (AVN), as both inferior and superior vascular entry points into the femoral head are ruptured.

Care must be taken to rule out slipped capital femoral epiphysis (SCFE). Fractures can be distinguished from SCFE by a detailed history supplemented by appropriate x-ray examination and assessment; in unclear situations, an MRI is indicated.

Note: Be aware of nonaccidental injuries in very young children.