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Paediatric post-traumatic cortical defects of the distal radius
Richard T Roach1, Victor Cassar-Pullicino, Bruce N Summers
1Department of Orthopaedics, Princess Royal Hospital, Telford, Shropshire TF6 6TF, UK.
Insights
Paediatric post-traumatic cortical defects, rare bone lesions after fractures, typically resolve with time and require no intervention. Imaging like CT and MRI aids in diagnosis.
Area of Science:
- Orthopaedic Surgery
- Paediatric Radiology
Background:
- Paediatric post-traumatic cortical defects are uncommon bone abnormalities.
- They predominantly affect the distal radius after greenstick or torus fractures.
Observation:
- Defects are often solitary on plain radiographs, appearing late and proximal to the fracture site.
- CT and MRI can identify smaller, multiple subperiosteal defects.
- These defects are non-expansile in healthy children.
Findings:
- The pathogenesis can be understood through images of acute greenstick fractures.
- Typical defects require only reassurance and advice regarding potential discomfort.
Implications:
- These findings suggest conservative management for most paediatric post-traumatic cortical defects.
- Understanding the imaging characteristics aids in accurate diagnosis and appropriate patient guidance.
Abstract:
Paediatric post-traumatic cortical defects, although rare, are predominately seen affecting the distal radius following a greenstick or torus fracture. We review the literature and present a further two cases supported by CT and MRI. Images from an acute greenstick fracture are also presented to help understand the pathogenesis. Defects are typically solitary on plain radiographs and are usually noticed late, proximal to the site of compression. They are non-expansile in an otherwise healthy child. CT and MRI may reveal smaller multiple subperiosteal defects. Typical defects require no further management other than reassurance and advice that they may occasionally cause discomfort but resolve with time.