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Typical bone fractures in children

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The bone in children is more porous and elastic than in adults. Due to its elasticity, fracture types in children are different than in adults.

Buckle or torus fracture

(Fig. 3) Compression along the bone hits the metaphyseal bone (area of greatest porosity) and bulges its cortical. It is a stable fracture (no tendency to move). Therefore, the treatment is usually a splint or a dressing for 2-3 weeks to avoid pain. It is more common in the wrist (distal radius) and shoulder (proximal humerus).

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Figura 3. Torus fracture

 

Diaphyseal plastic curvature

(Fig. 4): The shaft is arched without being fractured, by a turning mechanism, resulting in a permanent plastic deformation without remodeling capability because the periosteum is not broken. Hence, to rectify the bone, manipulation under anesthesia is required. It typically occurs in thin cortical bones such as the radius, ulna and fibula.

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Figure 4. Diaphyseal plastic curvature of the forearm bones (radius and ulna).

Greenstick fracture

(Fig 5): An incomplete fracture of the shaft by a turning mechanism. Similar to "chopping" a green cane. The bone on one side of the cortex is broken while the other side is bent and remains in continuity with the periosteum. The most common sites are the radius, ulna and clavicle bones.

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Figura 5. Greenstick fracture of the forearm bones (radius and ulna).

Subperiosteal fracture

The cortex breaks but the periosteum remains intact. It may go unnoticed in the first radiographs, being typical in the tibia of the "new walkers" (toddler fractures). They are more frequent in the lower extremities.


Physeal fracture

Growth plate (see “Physis” section)
Obstetric fractures (Fig 6): These occur during childbirth due to mechanical difficulties. A broken collarbone is the most common of this type, followed by the humerus fracture.

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Figura 6. Obstetric clavicular fracture.

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Typical bone fractures in children
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