Introduction and Aim: While displaced metaphyseal and diaphyseal fractures in children with severe spastic cerebral palsy have been reported in literature, there is no reference to epiphyseal separations in this group. Physeo-epiphyseal injuries have been reported in meningomyelocoele patients, but these injuries differ significantly in their etiology and natural history.

Method and Results: We report nine epiphyseal separations involving the distal femur and proximal humerus in four severely handicapped children with spastic cerebral palsy, and find scurvy to be the major cause of such epiphyseal slips. These epiphyseal slips have a good prognosis unlike those reported in MMC children. Treatment with vitamin C and splintage, without any attempt at reduction, resulted in rapid healing with excellent remodelling. Scurvy should be considered a potential cause for an epiphyseal slip in a child suffering from severe cerebral palsy.

Conclusion: We recommend routine vitamin C dietary supplementation in this group of malnourished, non-ambulant children.