Traumatic Bowing of the Bone in Children: Report of 3 Cases / 대한정형외과학회잡지

ABSTRACT

Bowing of one or both bones of the forearm in children following acute trauma was first recognized by Borden in 1974. Since then, a total of 30 cases have been reported in the English literature. The injury is a result of an acute plastic deformation of the tubular bones due to mainly a longitudinal compression force, and is charactcrized by 1) a broad fixed curvature of the entire bone, 2) absence of periosteal new bone formation on later roentgenograms, and 3) partial correction of the curvature through cortical remodeling in young children. In this paper, three cases of traumatic bowing of the tubular bone in children are presented one traumatic bowing of both forearm bones in 15 years old girl and two traumatic bowing of fibulae in combination with fractures of diaphysis of the tibiae of the same legs in 6 years old girl and 6 years old boy respectively. Manipulative reduction for the bowing of the both forearm bones corrected remarkably the plastic curvature, whereas manipulation for the bent fibulae with fractures of the tibiae failed to reduce the curvature, causing no delay in fracturt healing. These three cases are of special interest from two points of view. The first case was caused by tangential force instead of a longitudinal one and was associated with ulnar nerve paralysis which has eventually been recovered. The other two cases occurred in the lower leg in which plastic deformation, according to previous report, would not develop because of the lack of intrinsic curvature of the tibia and fibula.