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DOI: 10.1055/s-0031-1281660
© Georg Thieme Verlag KG Stuttgart · New York
Slipped Distal Humerus Epiphysis in Tiny Infants Easily Detected and Followed-Up by Ultrasound
Distale Humerusepiphysenlösung bei Säuglingen. Diagnose mittels UltraschallPublication History
received: 22.3.2011
accepted: 19.7.2011
Publication Date:
24 January 2012 (online)

Introduction
Impaired function of the upper extremity in newborns is either caused by congenital dysplasia or obstetrical trauma. The latter frequently results in fractures of the clavicle and plexus palsy or more rarely in a dislocated elbow joint or a slipped humerus epiphysis. In tiny infants both could be non-incidental as well. Due to the general absence of ossific nuclei in infants of this age and the rarity and unimpressive clinical appearance of such lesions, they are often missed or misinterpreted in the first instance.
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Prof. Andreas Fette
Medical School, University of Pecs
Hungary
Drosselstr. 4 Weissach im Tal
Germany
Phone: ++ 49/71 91/5 33 06
Fax: ++ 49/71 91/49 39 47
Email: andreas.fette@gmx.de