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This is Pediatrics week 4 case 5 and

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we have radiographs of the forearm

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and wrist of a six-year-old child with fall

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onto outstretched hand and so

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of course the injury that we're most suspicious of

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is a distal radial and ulnar fracture and

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sure enough. That's exactly what we're getting on this image. You

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can see that there is a subtle buckling

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right here.

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At the metaphysis or maybe you'd say the metadiaphysis of

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the distal radius and

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there's also just a very slight

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disruption of the normal trabeculae right in

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there take a look without The annotation. You can

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see it's a little bit more Lucent and there's a little bit

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of a Sawtooth pattern right in here

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where those trabeculy have been fractured. And in

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fact the fracture line in this case extends all the way

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up to the fisces and it turns out that in many

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cases of distal radial fracture, even though

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it's not clearly disrupted at the

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fisces. The fracture does extend all the way up. It also extends all

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the way across to the other side. This is called a buckle fracture

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or a Taurus fracture and that Taurus just

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as Latin for bump or

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a hump. And if you're looking at the Contour of the

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cortex, you can see just a very subtle little bump here.

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It's the Clue the other area you want to be aware

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of is the ulnar styloid in this case.

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Hardly even ossified but it's frequently fractured in

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association with a distal radial fracture.

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Over the years people have come up with names for these things colleagues fracture

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is one orientation of the

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fracture Smith fracture. All the eponyms may

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not be helpful here. The key thing is it's a sequela of

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following onto an outstretched hand. It typically

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does not disrupt the articulation between

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the distal radius and the carpus of the hand but this

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metaphaseal or meta-diaphaseal bone

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is where the fracture occurs on lateral view. You can

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see just a very subtle angulation right here in instead

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of a natural curvature that your clue of the

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fracture and these patients tend to

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do quite well and not require surgical repair given

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the non-displaced status of the fracture. That's the end

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of the case.