Incomplete fractures

Dr Jeremy Jones et al.

Incomplete fractures are a heterogeneous group of fractures that predominantly occur in the long bones of paediatric patients. Rang 1 describes a continuum of fractures that occur with increasing longitudinal force applied along the length of the bone. At the point where force exceeds the structural integrity of the bone, a complete fracture occurs.

The majority of forearm and lower leg fractures occur after indirect injury (e.g. the fall on an outstretched arm or jump from a height) rather than a direct injury (e.g. strike with a bat). In these situations, the force applied and the angulation of the force results in a variety of injuries.

Fracture types

With low energy impact, longitudinal force applied down a radius will result in bowing which, when the force is released returns to normal; the force results in elastic bowing that is not radiographically apparent since, by the time the film is obtained, the bone has returned to normal.

Bowing fracture

With greater force, the loaded bone undergoes plastic deformation resulting in clinically evident and radiographically proven bowing of the bone - a bowing fracture.

Torus fracture

If more force were applied the concave side of the bending bone would undergo compression fracture and a bulge would appear - a torus fracture. These usually occur in the metaphyseal regions, especially of the distal radius.

Greenstick fracture

If the bending bone is angulated slightly beyond it's limit of bending, there is complete failure of the convex cortex (the side of maximal tension) and only bending on the compression side. These greenstick fractures are far less common than torus fractures and are often more complete than initial radiographs demonstrate. Greenstick fractures tend to be mid-shaft injuries and may result from direct perpendicular trauma.

Share article

Article information

rID: 22210
Tags: refs, fracture
Synonyms or Alternate Spellings:

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Torus fracture
    Drag here to reorder.
  • Drag
    Greenstick fracture
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.