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CASE REPORT
Year : 1996  |  Volume : 42  |  Issue : 3  |  Page : 90-1

Plastic deformation of forearm.


Department of Orthopaedics, KEM Hospital, Parel, Mumbai.

Correspondence Address:
A A Bhaskar
Department of Orthopaedics, KEM Hospital, Parel, Mumbai.

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Source of Support: None, Conflict of Interest: None


PMID: 0009715328

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 :: Abstract 

The unusual occurrence of plastic deformation in an adult is described.


Keywords: Accidents, Occupational, Adult, Case Report, Forearm, pathology,Human, Humeral Fractures, radiography,surgery,Male, Multiple Trauma, radiography,surgery,Ulna Fractures, radiography,surgery,


How to cite this article:
Bhaskar A A, Shah S S. Plastic deformation of forearm. J Postgrad Med 1996;42:90

How to cite this URL:
Bhaskar A A, Shah S S. Plastic deformation of forearm. J Postgrad Med [serial online] 1996 [cited 2019 Aug 23];42:90. Available from: http://www.jpgmonline.com/text.asp?1996/42/3/90/427





  ::   Case report Top


A 22-year-old man, textile worker was admitted with polytrauma at King Edward Memorial Hospital, Bombay. He had sustained an unusual injury while working in the textile factory. His entire body was caught between rotating cylinders that are used to wind cloth. The entire episode was over quickly. The patient came to the emergency ward in a state of shock. Roentgen examination revealed bilateral fracture shaft femur in the middle third region-transverse, fracture of right humerus in the distal one-third with, an unusual posterior bow and a plastic deformation of both radius-ulna on the right side. [Figure - 1] & [Figure - 2] The proximal and distal radius-ulna joint were normal and fracture of ulna styloid was seen. [Figure - 3]

After the patient was haemodynamically stabilised, he was operated for fracture shaft femur and humerus. There was no attempt made to correct the forearm curvature. Patient was asymptomatic for the forearm deformity except terminal restriction of pro-nation. There was no sign of periosteal callus formation in the deformed bones. No functional disability is attributed to the bowing except the obvious cosmetic deformity.


  ::   Discussion Top


Plastic deformation refers to bending of the bone without any evidence of discontinuity in the cortex. Bone is in a state of dynamic biomechanical flux at different age groups. While bone has been considered a brittle material when loaded in tension, it has become evident that bone initially exhibits ductile behaviour.

Elongation of bone tissue under tensile or elongating loads may continue between 2 percent and 7 percent of the overall length of the bone depending on the age and area of bone. After this continued elongation results in permanent plastic deformation which is essentially an irreversible process. Microscopically, plastic deformation is characterised by small fractures along the concave border of the tubular bone. If a plastically deformed bone is subsequently clinically loaded, the total deformation will increase until a point when the last load applied will result in failure (i.e. fracture)[1].

Plastic deformation always occurs in children due to a large plateau of plastic response present compared to that of an adult[2]. It has been rarely reported in adults. The oldest individual in Rydholms[3] series was sixteen years. Some remodelling of the deformity can occur in patients less than 10 years of age. However, no periosteal callus may be seen for several months.

Correction of significant bowing must be attempted in the acute phase under general anaesthesia. A great deal of force and manipulation will be required to slowly straighten the curvature. Immobilisation in a long arm cast is necessary for 6 weeks to achieve healing and avoid recurrence of deformity[1].

 
 :: References Top

1. Rockwood AC, Wilkins EK. Fractures in children (Vol. 3). JB Lippincott Company; 1984.  Back to cited text no. 1    
2.Chamay A. Mechanical and Morphological Aspects of Experimental overload and Fatigue in Bone. J Biomech 1970; 3:263-270.  Back to cited text no. 2    
3.Rydholm V, Nilssen JE. Traumatic Bowing of Forearm. Clin Orthop 1979; 139:121-124.   Back to cited text no. 3    


    Figures

[Figure - 1], [Figure - 2], [Figure - 3]

This article has been cited by
1 Plastic deformation of the forearm in an adult - Treatment with multiple osteotomies
Lefaivre KA, Slobogean GP, OBrien PJ
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH. 2007; (462): 234-237
[Pubmed]



 

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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
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