Bowing fracture

Bowing fractures are incomplete fractures of tubular long bones in paediatric patients (especially the radius and ulna), often require no intervention and heal with remodelling.

Pathology

When an angulated longitudinal force is applied to a bone, the bone bends. Paediatric 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.

However, if the force is greater than the mechanical strength of the bone, rather than elastic deformation, the bone undergoes plastic deformation and when the force is released, the bone remains in its bowed position.

Careful examination of the bone reveals that there are microfractures along the concave border of the bowed bone, but these are not visible radiographically.

Radiographic features

Plain film
  • bowing of the bone
  • absence of visible cortical injury

Differential diagnosis


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Fractures

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