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Case of the Week 319

What's the most likely diagnosis?

  • 4 year old male with deformity of the forearm after falling from play gym

Two views of the forearm

  1. Galeazzi fracture-dislocation
  2. Fracture of the ulna
  3. Monteggia fracture-dislocation
  4. Fracture of the radius
  5. Fracture of radius with plastic bowing of ulna

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5. Fracture of radius with plastic bowing of ulna

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Fracture of radius with plastic bowing of ulna

General Considerations

  • Deformation of the bone due to longitudinal stress
  • Almost exclusively in children ages 2-5
  • Produced by numerous microfractures on the concave surface of the bone with an intact cortex on the convex surface
  • Most common in the forearm and may affect radius or ulna
    • Most common form involves bowing of ulna with fracture of radius
  • Rarity of these injuries (relative to actual fracture) is due to fact that
    • Force must be exactly longitudinal
    • Force must be greater than the maximal strength of the bone, and
    • The force must be of shorter duration than the time it would take for a gross fracture to occur
  • May also occur in the femur and fibula

More ...

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