31-E/2.1   Epiphysiolysis with metaphyseal wedge, SH II

The pattern of this rare fracture is a traumatic separation of the proximal femoral epiphysis with a metaphyseal wedge. The wedge is usually located inferiorly.

As the head is displaced inferiorly, and a metaphyseal wedge remains attached to the head, the inferior vessels supplying the capital epiphysis are usually spared, reducing the risk of AVN.

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