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FIGURE 111.3 Anteroposterior (A ) and lateral (B ) radiographs of a distal radius torus
fracture. (Reprinted with permission from Waters PM, Skaggs DL, Flynn JM. Rockwood and
Wilkins’ Fractures in Children . 9th ed. Philadelphia, PA: Wolters Kluwer; 2020.)

FIGURE 111.4 Greenstick fracture of the ulna (large arrow ) and a bowing fracture (small
arrows ) of the radius. The extent of bowing can often be fully appreciated only with
comparison views of the opposite extremity.

Bowing Fractures
Bowing fractures occur uniquely in children. Evidence suggests that the
mechanism is a longitudinal force causing “plastic” deformation (bowing), but
stops short of creating a fracture ( Fig. 111.4 ). Little remodeling can be expected
from the injury, and both cosmetic and functional deficits are common. Anatomic
reduction produces the most satisfactory result. All bowing deformities should be
referred to an orthopedic surgeon.