Bead breakage

Definition

A bead fracture, also called toric fracture, is a colloquially called incomplete fracture of a bone, which occurs especially in childhood. This type of fracture usually occurs on long tubular bones such as the forearm or lower leg bones when they are still growing. It is usually a compression fracture that causes a bulge fracture.

In the case of a “fracture”, however, this does not result in the formation of two bone fragments. Rather, only the inner layers of the bone are broken, whereas the outer periosteum remains intact and ensures that no separate parts are formed. The X-ray image shows the bulge fracture with a bulge at the supposedly fractured site, which also explains the name.

Therapy

The treatment of bead fracture is usually conservative. In concrete terms, this means that no surgery on the fracture is necessary. The fact that the periosteum around the fracture is still intact ensures good healing results with a conservative approach.

If the bone slips slightly, it is moved back into the correct position under the control of an X-ray and then fixed in place with the aid of a plaster cast. Immobilization is normally only necessary for about four weeks. In this case, surgery would only involve manipulation of the bone growth center, which can prevent the bone from growing further.

It is generally recommended to treat childhood fractures with as little manipulation of the growth centers as possible. Only if the bone ends are not in a straight line can surgery be of additional help. In this case, there are various stabilization options, such as wires or plates, which immobilize the fracture.

In the case of severe pain, pain treatment with ibuprofen or paracetamol can also be performed on children. Depending on the fracture site, physiotherapy can support the healing process to restore full movement. The affected bone should not be subjected to full weight-bearing directly, as this will encourage renewed fractures at the old fracture site.

Unusual fractures, such as the collarbone, cannot be plastered and must therefore be stabilized with special splints. Usually the cast is worn on the arm for four to six weeks. This period should give the bone time to grow together again properly. This period is also observed for injuries to the lower leg bones in order to allow the bone to adapt properly. If the collarbone is broken, however, only the shoulder affected can be immobilised so that the bone can heal again.