Slipped distal femoral epiphysis in congenital insensitivity
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Congenital insensitivity to pain (CIP) is a rare disorder and often presents to an orthopedic surgeon as recurrent fractures, dislocations, pseudoarthrosis,osteomyelitis etc. Here, we report a case of congenital insensitivity to pain presenting with distal femoral physeal separation in a child.A 12-year-old girl child came with complaints of a limp while walking and swelling in the left knee for past 5 weeks.Mother gave a history that the girl is a known case of congenital insensitivity to pain with a clear history of no pain on intramuscular injection since birth. She was born of consanguineous marriage and had no significant trauma, fever, other joint involvement or any features of rheumatism. On local examination, she had no bony tenderness, mild warmth and moderate knee effusion with restricted range of movement. The plain radiograph showed epiphysiolysis of the distal femur with the widening of physis. Examination under anesthesia demonstrated gross movement indicating lower femoral physeal separation. This unstable distal femoral epiphysis was treated under general anesthesia with closed reduction, percutaneous cross-pinning and above knee plaster cast.

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Dr. S●●●●●r S●●●●a and 3 others like this
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