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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
- Pediatric bones more elastic than adult bones
- 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
- Incomplete fracture: Macroscopic fracture line does not traverse entire bony diameter
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
- Herren C et al: Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res. 101(4):501-5, 2015
- 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
- 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
- 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
- Bae DS: Pediatric distal radius and forearm fractures. J Hand Surg Am. 33(10):1911-23, 2008
- 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
- Carson S et al: Pediatric upper extremity injuries. Pediatr Clin North Am. 53(1):41-67, v, 2006
- Sai S et al: Radial head dislocation with acute plastic bowing of the ulna. J Orthop Sci. 10(1):103-7, 2005
- Swischuk LE et al: Frequently missed fractures in children (value of comparative views). Emerg Radiol. 11(1):22-8, 2004
- Roach RT et al: Paediatric post-traumatic cortical defects of the distal radius. Pediatr Radiol. 32(5):333-9, 2002
- 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
- Miller JH et al: Scintigraphy in acute plastic bowing of the forearm. Radiology. 142(3):742, 1982
- Martin W 3rd et al: Acute plastic bowing fractures of the fibula. Radiology. 131(3):639-40, 1979
- 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
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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
- Pediatric bones more elastic than adult bones
- 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
- Incomplete fracture: Macroscopic fracture line does not traverse entire bony diameter
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
- Herren C et al: Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res. 101(4):501-5, 2015
- 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
- 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
- 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
- Bae DS: Pediatric distal radius and forearm fractures. J Hand Surg Am. 33(10):1911-23, 2008
- 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
- Carson S et al: Pediatric upper extremity injuries. Pediatr Clin North Am. 53(1):41-67, v, 2006
- Sai S et al: Radial head dislocation with acute plastic bowing of the ulna. J Orthop Sci. 10(1):103-7, 2005
- Swischuk LE et al: Frequently missed fractures in children (value of comparative views). Emerg Radiol. 11(1):22-8, 2004
- Roach RT et al: Paediatric post-traumatic cortical defects of the distal radius. Pediatr Radiol. 32(5):333-9, 2002
- 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
- Miller JH et al: Scintigraphy in acute plastic bowing of the forearm. Radiology. 142(3):742, 1982
- Martin W 3rd et al: Acute plastic bowing fractures of the fibula. Radiology. 131(3):639-40, 1979
- 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
