Delayed separation of the capital femoral epiphysis after an ipsilateral transcervical fracture of the femoral neck.

A displaced transcervical fracture of the femoral neck in a three-year-eight-month-old boy was fixed with two screws, which did not cross the growth plate. When he resumed walking five weeks after the injury, a delayed separation of the capital femoral epiphysis occurred. The displaced epiphysis was reduced and fixed with three unthreaded pins. In spite of disruption of the femoral neck at two sites, avascular necrosis of the femoral head did not occur. This was confirmed by two sequential isotope scans. Delayed epiphyseal separation after the femoral neck fracture and the preservation of the vascularity of the epiphysis in this case are both very unusual.