Separation of the proximal femoral epiphysis can occur in a child with a traumatic hip dislocation and an open physis. This injury has been reported to occur either as a result of direct trauma (with or without a hip dislocation) or during the reduction of a dislocated hip. This injury occurs in association with approximately 2% of all hip dislocations in patients with an open physis.Regardless of the mechanism of proximal femoral epiphy-seal separation, the prognosis is poor secondary to the development of osteonecrosis. Independent of the method or timing of treatment, the development of osteonecrosis has been reported to be 100%5. The long-term outcome for these patients is dismal, with most patients requiring hip salvage procedures and, ultimately, either arthrodesis or total hip arthroplasty.
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