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Gunshot injury of the proximal femoral physis

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Abstract

A 12-year-old boy sustained a gunshot injury to the proximal femur. The bullet hole passed through the femoral neck very close to the proximal femoral physis (Ogden type 8 physeal injury) without neurovascular injury. The boy was treated conservatively with antibiotics and bedrest. Nine months later, avascular necrosis of the femoral head (Ratliff type 2) and limb shortening of 2 cm had developed. For this reason, a valgus intertrochanteric osteotomy was performed 1 year after the injury. However, only partial revascularization of a necrotic femoral head segment occurred. For the residual necrotic segment in the weight-bearing area and progressive shortening of the femur 3.5 years after injury, a valgus-extension intertrochanteric osteotomy was performed and remodelling of the necrotic fragment done. The boy is now over 19 years old. He has only minimal pain after sports activity and a slightly limited range of movement. The limb shortening is 1.5 cm.

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Acknowledgement

The study was prepared with a grant of the Ministry of Health of the Czech Republic (grant IGA MZ ND 7022–3).

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Authors and Affiliations

  1. Orthopaedic Department of 3rd Faculty of Medicine, Charles University, Šrobárova 50, 100 34 , Prague 10, Czech Republic

    Jan Bartoníček & Petr Havránek

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  1. Jan Bartoníček
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  2. Petr Havránek
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Correspondence to Jan Bartoníček.

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Bartoníček, J., Havránek, P. Gunshot injury of the proximal femoral physis. Arch Orthop Trauma Surg 124, 69–71 (2004). https://doi.org/10.1007/s00402-003-0600-2

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  • DOI: https://doi.org/10.1007/s00402-003-0600-2

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