Most authors agree that where angulation is less than 20 degrees, manipulation for reduction is not required and only symptomatic support is required: this is usually in the form of a removable splint. Some advocate the reduction of a bowing fracture where angulation exceeds 20 degrees. In isolation, treatment of bowing fractures is debated 2. Treatment and prognosisīowing fractures usually accompany another fracture and in those cases, treatment is determined according to the type and severity of the accompanying injury. In some cases, there may be dislocation of the paired bone, e.g. radius, and this is usually diaphyseal (either greenstick or complete). There is usually an accompanying fracture of a paired bone, e.g. There is no fracture line or visible cortical injury. The bowing tends to be fluid and blend into the normal bone at either end. If the view is in the plane of the bow, the bone may appear completely normal 1. On a plain film, bowing of the bone can be visualized provided that the view is in a different plane to the direction of bowing. Microscopic examination of the bone reveals that there are microfractures along the concave border of the bowed bone, but these are not visible radiographically. If the force is greater than the mechanical strength of the bone, the bone undergoes plastic deformation and when the force is released, the bone remains in its bowed position. This ability to bend occurs because the cortex is thinner in absolute and relative terms compared to adult bones and because of the way the cortex and periosteum bind to each other in the developing skeleton. Pediatric bones have a degree of elasticity and therefore, if the force is low and subsequently released, the bone returns to its normal position and no lasting evidence of that bowing is seen radiographically. When an angulated longitudinal force is applied to a bone, the bone bends. What are the common causes of a buckle fracture It commonly happens after a falling onto an outstretched hand but can also occur after a. It is a very common fracture in children. It is a minor fracture which heals with minimal intervention. This is often after falling from furniture or climbing equipment, especially monkey bars. This type of fracture or break is called a buckle or torus fracture. Clinical presentationĬhildren present with pain and swelling following a fall, usually on an outstretched hand. However, bowing fractures of all long bones have been described. The radius and ulna are the most commonly affected bones, followed by the fibula. These injuries usually occur in children although adolescents may be affected. However, there have been several case reports of bowing in adult bones. doi:10.Bowing fractures are almost exclusively found in children. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India. This may be due to the relative scarcity in guidelines compiling all the available research together in order to recommend a comprehensive. The usefulness of CT for patients with carpal bone fractures in the emergency department. A survey of orthopaedic surgeons found that 73.8 of consultants still used plaster-of-Paris back slabs, 24.6 used full plaster-of-Paris casts and only 1.5 used wrist splints to manage torus fractures. You JS, Chung SP, Chung HS, Park IC, Lee HS, Kim SH. Spectrum of carpal dislocations and fracture-dislocations: imaging and management. Scalcione LR, Gimber LH, Ho AM, Johnston SS, Sheppard JE, Taljanovic MS. Radiographics : a review publication of the Radiological Society of North America, Inc. The word torus is derived from the Latin word Tori meaning swelling or protuberance. Because children have softer bones, one side of the bone may buckle. Multidetector CT of carpal injuries: anatomy, fractures, and fracture-dislocations. Torus fractures, or buckle fractures, are extremely common injuries in children. Kaewlai R, Avery LL, Asrani AV, Abujudeh HH, Sacknoff R, Novelline RA.
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