Presentation
Right hip is painful to the touch after a motorcycle accident.
Patient Data
Fracture of the right femoral shaft.
3-day follow-up revealed loss of reduction.
1-week follow-up with an already visible callus formation.
4-week follow-up with large callus formation. Remodeling of the fracture is gradually correcting the varus angulation, which is much less accentuated compared to the follow-up performed one week after the trauma.
Case Discussion
Callus formation is part of the process of fracture healing. The current remodeling stage may last for several years. Given the child is only 2-month-old at the time, there is still great remodeling potential and the angular deformity may be completely corrected over time.
Something important to point out in the present case is the fact that a 1-month-old patient was presented to the trauma center with a femoral shaft fracture. In children younger than 3 years of age a long bone fracture is a red flag for physical abuse.
Non-accidental injury was discarded though. Social services interviewed the parents and confirmed the trauma was due to a motorcycle accident involving both parents and the child. Although transporting children younger than 10 years of age on motorcycles is prohibited by Brazilian law, the practice is still extremely common, especially among more underprivileged populations.
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