CHAPTER 40

Fracture Types Overview

Plastic Deformation

• Instead of incurring a complete or incomplete break or fracture, an immature bone can bend or bow (Figures 40-1 and 40-2).

• Usually occurs in response to a longitudinally applied force but less commonly after a transverse blow. Usually found in conjunction with a fracture of the radius or tibia.

• Most commonly occurs in the ulna or fibula

• Remodeling potential is very good in children younger than 6 years.

• A deformity of more than 10 degrees in a child older than 6 years should be reduced.

Buckle or Torus Fractures

• Commonly occur with a fall onto an outstretched hand

• Occur at the diaphyseal-metaphyseal junction, when denser diaphyseal bone compresses the neighboring softer metaphyseal bone (Figure 40-3).

• Most common fracture type in children

• Often subtle radiographically; usually non-displaced

• Frequently present without swelling, loss of motion, or much pain

• Delayed presentation is common and does not raise suspicion for abuse.

Figure 40-1.

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