Bowing Fractures: Rare But Significant

Two case reports and a brief discussion provide a practical review of plastic bowing fractures. These uncommon fractures occur almost exclusively in children; if missed and untreated, significant deformity may ensue.

Bowing fractures usually involve the forearm, but can also occur in the tibia, fibula, and femur. The usual cause is a fall onto an outstretched hand, resulting in axial compression and multiple microfractures. The bowing of one bone is often associated with a diaphyseal fracture of the other. The resulting plastic deformation presents as an exaggerated curve. The child usually reports diffuse pain and shows deformity and limitation of supination and pronation. Comparison views of the uninvolved forearm may aid diagnosis. Depend…