Distal radius and ulna greenstick fractures

Case contributed by Leonardo Lustosa


Fall onto the outstretched hand. Obvious forearm deformity upon physical examination.

Patient Data

Age: 5 years
Gender: Male

Radiographs revealed distal metaphyseal greenstick fractures of the radius and ulna. There are ulnar (medial) and dorsal angulation components. 

After closed reduction


Follow-up radiographs after closed reduction. The ulnar and dorsal displacement has been reduced.

Case Discussion

Forearm fractures are the most common long bone fractures in children. Fall onto the outstretched hand is the main mechanism of injury.

Distal radius fractures are common fractures in children, sometimes associated with distal ulna fractures. Due to skeletal immaturity, they may present as greenstick fractures

In children, the initial approach is usually non-operative. Acceptable residual angulation after closed reduction depends on age. In the present case, the boy was 5 years old, to which the residual acceptable angulation on the sagittal plane is up to 20º, and up to 15º on the coronal plane.

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