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Il Giornale Italiano di Radiologia Medica 2018 Marzo-Aprile;5(2):288-92

DOI: 10.23736/S2283-8376.18.00039-6


language: Italian

Pediatric traumatology: bowing fracture. Description of a case and literature review

Zairo FERRANTE 1 , Antonio VIZZUSO 2, Fabio PELLEGRINO 2, Tommaso VENTRE 3, Melchiore GIGANTI 2, Stefano TARTARI 1, Giorgio BENEA 1

1 Radiologia Ospedaliera, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italia; 2 Scuola di Specializzazione Radiodiagnostica, Università degli Studi di Ferrara, Ferrara, Italia; 3 Dipartimento di Ortopedia e Traumatologia, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italia


Post-traumatic plastic deformation or “Bowing fracture” consists in a stable deformation of the bone after trauma, which tends to assume an arched appearance. It can be considered as a lesion that precedes “green wood” fractures. It is typical of the paediatric age because the baby’s bone, in relation to its high plasticity, can deform if exposed to compressive forces without typical radiographic signs of fracture. In fact, when an increasing longitudinal force is applied to a long bone, it responds by deforming in an “elastic” way and returns to the starting conditions if the stress has short intensity and duration. On the contrary, the bone deforms in a “plastic” and permanent way because of greater intensity and duration of stress (in this case the bending bone persists even beyond the end of the stress). Therefore, the lesion must be unequivocally considered as a fracture and treated as such. The degree of deformity varies greatly and its identification requires a careful examination of the radiographs. Often it may need to resort to comparative radiographic study of the healthy counter-lateral region. For the identification and the clinical-therapeutic management of these lesions, conventional radiography is the gold standard, considering the age of patients and their relative simplicity. Other imaging techniques such as US, CT, MRI and scintigraphy may be useful, but only as complementary tools, in carefully selected cases.

KEY WORDS: Traumatology - Musculoskeletal disease - Child

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