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Chapter 65

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1. Greenstick fracture

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Figure 65-1

Greenstick fracture.

An AP radiograph shows slight apex lateral bowing of the distal ulnar diaphysis. There is a thin fracture line (arrow) along the convex side of the bowed segment. The fracture has a steep oblique configuration peripherally and turns longitudinally in the central aspect. The cortex along the concave aspect is intact.

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2. Torus fracture of the radius

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Figure 65-2

Torus fracture of the radius.

A. A lateral radiograph obtained of a child with wrist pain following a fall on an outstretched arm demonstrates dorsal cortical buckling of the distal portion of the radius (arrow). The anterior cortical margin is intact. B. There is only minimal cortical irregularity on the AP view (arrow). A radiolucent fracture line is lacking.

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3. Torus fracture

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Figure 65-3

Torus fracture.

A lateral projection radiograph shows cortical buckling in the distal femoral diaphysis of a 12-month-old child. A radiolucent fracture line extends deep to the cortical injury. The anterior cortex is intact.

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4. Lead pipe fracture

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Figure 65-4

Lead pipe fracture.

A lateral wrist radiograph of a 15-month-old child shows an incomplete distal radial fracture (arrow), with cortical buckling dorsally and cortical disruption anteriorly. There is also a subtle dorsal cortical buckle fracture of the ulnar metaphysis.

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5. Plastic deformation injury

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Figure 65-5

Plastic deformation injury.

A. An AP view of a toddler a few hours after a fall shows medial bowing of the fibula but no visible fracture line. B. Seven days later, periosteal new bone is present along the bowed portion of the diaphysis (arrows).

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6. Cuboid fracture

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Figure 65-6

Cuboid fracture.

This 2-year-old child presented with a limp following a fall. Initial radiographs (not shown) were normal. A, B. Lateral (A) and plantar (B) bone scintigraphy images show markedly increased uptake in the cuboid bone (arrows). C. An oblique radiograph obtained 1 week later shows increased density along the proximal aspect of the cuboid (arrow), due to compressed trabeculae and reactive new bone formation.

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7. Toddler fracture

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Figure 65-7

Toddler fracture.

Tibial diaphyseal fractures in 3 young children. A. There is a classic spiral fracture (arrow) in this 19-month-old child. ...

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