What Types of Forearm Fractures Occur in Children?

Forearm fractures are some of the most common injuries seen in children. Kids are naturally active, and when they fall, they often try to catch themselves with an outstretched hand. This puts a lot of force on the radius and ulna, the two bones in the forearm.

Children’s bones are different from adult bones. They are more flexible and covered by a thicker outer layer called the periosteum. Because of this, children’s bones tend to break in unique ways.

Types of Pediatric Forearm Fractures

Knowing the different types of pediatric forearm fractures can help parents better understand the injury and the recovery process. Here are some common types:

Greenstick Fractures

A greenstick fracture is one of the most common bone injuries in children. It happens when a child’s flexible bone bends and cracks on one side but does not break all the way through, similar to how a young tree branch bends without snapping.

This type of fracture usually occurs when a child falls onto an outstretched arm. Treatment typically involves placing the arm in a cast to keep the bone stable while it heals. Because children’s bones heal quickly, greenstick fractures usually recover well with proper care.

Torus (Buckle) Fractures

Torus fractures, also known as buckle fractures, are especially common in younger children. Instead of cracking or snapping, the bone compresses and causes one side to bulge outward. This type of injury often happens after a fall and may not look serious at first.

The arm may only appear swollen or tender, with no obvious bending or deformity. Doctors perform X-rays to confirm the fracture. Treatment usually includes a splint or cast, and healing is typically fast and uncomplicated.

Growth Plate (Physeal) Fractures

Growth plate fractures affect the soft areas of cartilage at the ends of long bones where growth takes place. These areas are weaker than the surrounding bone, making them more vulnerable to injury.

If a growth plate fracture is not treated correctly, it can interfere with normal bone growth and may cause the arm to grow unevenly or become shorter over time. Doctors use the Salter-Harris classification system to determine the type and severity of the fracture, which helps guide proper treatment and follow-up care.

Galeazzi and Monteggia Fractures

Galeazzi and Monteggia fractures are more complex injuries because they involve both a bone fracture and a joint dislocation. A Monteggia injury involves a fracture (or bending deformity) of the ulna near the elbow with dislocation of the radial head.

A Galeazzi injury involves a fracture of the radius (usually the distal third) along with injury/instability of the distal radioulnar joint (the joint between radius and ulna at the wrist).

These injuries usually result from high-impact falls or trauma. Treatment often requires carefully realigning the bones and joints, and in some cases, surgery is needed to ensure proper healing and joint stability.

Complete Fractures

Complete fractures occur when the bone breaks entirely into two separate pieces. These fractures can vary in severity depending on how the broken ends line up. In non-displaced fractures, the bone pieces remain aligned and may heal with casting alone. Displaced fractures involve bones that have shifted out of position and usually need to be realigned before casting.

Compound, or open, fractures are the most serious, as the bone breaks through the skin. These require emergency medical treatment due to the high risk of infection and often involve surgery and antibiotics to ensure safe healing.

Wrapping Up

The good news for parents is that children’s bones can heal and reshape themselves over time. Children can remodel some angulation over time, especially when they’re younger and the fracture is near a growth plate. However, certain deformities (especially rotation) may not correct on their own; the right diagnosis is very important.

Consult our board-certified orthopedic surgeon, Dr. Randy Y. Luo, MD, MBA, for fracture care. Call us today to book an appointment.