Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Orthop. May 18, 2012; 3(5): 58-61
Published online May 18, 2012. doi: 10.5312/wjo.v3.i5.58
Scurvy: An unusual presentation of cerebral palsy
Sumit Gupta, Rajesh Kanojia, Ashish Jaiman, Dhananjaya Sabat
Sumit Gupta, Senior Resident, Department of Orthopedics, Lady Hardinge Medical College, New Delhi 11070, India
Rajesh Kanojia, Department of Orthopedics, Lady Hardinge Medical College, New Delhi 110070, India
Ashish Jaiman, Safderjung Hospital, New Delhi 110070, India
Dhananjaya Sabat, Maulana Azad Medical College, New Delhi 110070, India
Author contributions: The case was diagnosed by Jaiman A; the manuscript was written by Gupta S and Sabat D; final editing was done by Kanojia R.
Correspondence to: Dr. Sumit Gupta, Senior Resident, Department of Orthopedics, Lady Hardinge Medical College, New Delhi 110070, India. drsumitlhmc@gmail.com
Telephone: +91-98-99750676 Fax: +91-98-99750676
Received: February 16, 2012
Revised: April 1, 2012
Accepted: May 13, 2012
Published online: May 18, 2012
Abstract

Scurvy is caused by prolonged severe dietary deficiency of ascorbic acid, in which the breakdown of intercellular cement substances leads to capillary hemorrhages and defective growth of fibroblasts, osteoblasts and odontoblasts, resulting in impaired synthesis of collagen, osteoid and dentine. It is characterized by hemorrhagic gingivitis, subperiosteal hemorrhages, perifollicular hemorrhages, and frequently petechial hemorrhages (especially on the feet). People with abnormal dietary habits, mental illness or physical disability are prone to develop this disease. Epiphyseal separation is known to occur in scurvy but is rarely seen now. Epiphyseal separation from the metaphysis is always through the zone of calcified cartilage, known as “scorbutic lattice”, which in the radiographs is represented as “the white line of Frenkel”. We report a case of multiple epiphyseal separations in a cerebral palsy child because of vitamin C deficiency. The child was treated with splintage of extremity and nutritional supplementation. All physeal separation healed completely without any deformity.

Keywords: Multiple epiphyseal separation, Scurvy, Cerebral palsy