Circumferential growth plate fracture of the thoracolumbar spine from child abuse

We report a unique fracture dislocation of the immature spine associated with child abuse and paraplegia. Because it occurs through growth centers, this fracture may be initially difficult to identify without special studies. The fracture patterns were isolated injuries in both children and were best shown with computer tomography. Mechanisms of injury are proposed and should suggest child abuse as a cause. Experience with these initial cases has suggested a treatment approach based on the mechanism of injury. There is no indirect means of reduction for this fracture and anterior open reduction is the treatment of choice.