link
Bookmarks
Incomplete Fractures
A. Carlson Merrow, Jr., MD, FAAP
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
7
0
0

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Buckle (torus), plastic (bowing), greenstick fractures
            • Definitions

              • Incomplete fracture: Macroscopic fracture line does not traverse entire bony diameter
                • Pediatric bones more elastic than adult bones
                  • Greater propensity to bow or bend before breaking
              • Greenstick fracture: Discrete fracture line on tension side does not extend through opposite cortex
                • Appearance of bent immature tree branch ("green stick")
              • Plastic deformation: Smooth but accentuated bending of shaft without visible fracture line
                • "Bowing fracture"
              • Buckle fracture: Focal outward bulge of cortex (without frank interruption) on compression side; cortex usually intact on tension side
                • "Torus" term no longer in favor (as it implies circumferential bulging)
              • Incomplete fracture with cortical disruption: Frank cortical disruption/angulation on compression side

            IMAGING

            • General Features

              • Radiographic Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Herren C et al: Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res. 101(4):501-5, 2015
                                    2. Kim E et al: Three-dimensional analysis of acute plastic bowing deformity of ulna in radial head dislocation or radial shaft fracture using a computerized simulation system. J Shoulder Elbow Surg. 21(12):1644-50, 2012
                                    3. Pountos I et al: Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single blind study. J Child Orthop. 4(4):321-6, 2010
                                    4. Schmuck T et al: Greenstick fractures of the middle third of the forearm. A prospective multi-centre study. Eur J Pediatr Surg. 20(5):316-20, 2010
                                    5. Bae DS: Pediatric distal radius and forearm fractures. J Hand Surg Am. 33(10):1911-23, 2008
                                    6. Bochang C et al: Are frequent radiographs necessary in the management of closed forearm fractures in children? J Child Orthop. 2(3):217-20, 2008
                                    7. Carson S et al: Pediatric upper extremity injuries. Pediatr Clin North Am. 53(1):41-67, v, 2006
                                    8. Sai S et al: Radial head dislocation with acute plastic bowing of the ulna. J Orthop Sci. 10(1):103-7, 2005
                                    9. Swischuk LE et al: Frequently missed fractures in children (value of comparative views). Emerg Radiol. 11(1):22-8, 2004
                                    10. Roach RT et al: Paediatric post-traumatic cortical defects of the distal radius. Pediatr Radiol. 32(5):333-9, 2002
                                    11. Proubasta IR et al: Entrapment of the median nerve in a greenstick forearm fracture. A case report and review of the literature. Bull Hosp Jt Dis. 58(4):220-3, 1999
                                    12. Miller JH et al: Scintigraphy in acute plastic bowing of the forearm. Radiology. 142(3):742, 1982
                                    13. Martin W 3rd et al: Acute plastic bowing fractures of the fibula. Radiology. 131(3):639-40, 1979
                                    14. Borden S 4th: Roentgen recognition of acute plastic bowing of the forearm in children. Am J Roentgenol Radium Ther Nucl Med. 125(3):524-30, 1975
                                    Related Anatomy
                                    Loading...
                                    Related Differential Diagnoses
                                    Loading...
                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Synonyms

                                                • Buckle (torus), plastic (bowing), greenstick fractures
                                              • Definitions

                                                • Incomplete fracture: Macroscopic fracture line does not traverse entire bony diameter
                                                  • Pediatric bones more elastic than adult bones
                                                    • Greater propensity to bow or bend before breaking
                                                • Greenstick fracture: Discrete fracture line on tension side does not extend through opposite cortex
                                                  • Appearance of bent immature tree branch ("green stick")
                                                • Plastic deformation: Smooth but accentuated bending of shaft without visible fracture line
                                                  • "Bowing fracture"
                                                • Buckle fracture: Focal outward bulge of cortex (without frank interruption) on compression side; cortex usually intact on tension side
                                                  • "Torus" term no longer in favor (as it implies circumferential bulging)
                                                • Incomplete fracture with cortical disruption: Frank cortical disruption/angulation on compression side

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • Ultrasonographic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Herren C et al: Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res. 101(4):501-5, 2015
                                                                      2. Kim E et al: Three-dimensional analysis of acute plastic bowing deformity of ulna in radial head dislocation or radial shaft fracture using a computerized simulation system. J Shoulder Elbow Surg. 21(12):1644-50, 2012
                                                                      3. Pountos I et al: Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single blind study. J Child Orthop. 4(4):321-6, 2010
                                                                      4. Schmuck T et al: Greenstick fractures of the middle third of the forearm. A prospective multi-centre study. Eur J Pediatr Surg. 20(5):316-20, 2010
                                                                      5. Bae DS: Pediatric distal radius and forearm fractures. J Hand Surg Am. 33(10):1911-23, 2008
                                                                      6. Bochang C et al: Are frequent radiographs necessary in the management of closed forearm fractures in children? J Child Orthop. 2(3):217-20, 2008
                                                                      7. Carson S et al: Pediatric upper extremity injuries. Pediatr Clin North Am. 53(1):41-67, v, 2006
                                                                      8. Sai S et al: Radial head dislocation with acute plastic bowing of the ulna. J Orthop Sci. 10(1):103-7, 2005
                                                                      9. Swischuk LE et al: Frequently missed fractures in children (value of comparative views). Emerg Radiol. 11(1):22-8, 2004
                                                                      10. Roach RT et al: Paediatric post-traumatic cortical defects of the distal radius. Pediatr Radiol. 32(5):333-9, 2002
                                                                      11. Proubasta IR et al: Entrapment of the median nerve in a greenstick forearm fracture. A case report and review of the literature. Bull Hosp Jt Dis. 58(4):220-3, 1999
                                                                      12. Miller JH et al: Scintigraphy in acute plastic bowing of the forearm. Radiology. 142(3):742, 1982
                                                                      13. Martin W 3rd et al: Acute plastic bowing fractures of the fibula. Radiology. 131(3):639-40, 1979
                                                                      14. Borden S 4th: Roentgen recognition of acute plastic bowing of the forearm in children. Am J Roentgenol Radium Ther Nucl Med. 125(3):524-30, 1975