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Development and Duration of Radiographic Signs of Bone Healing in Children

Omar Islam1, Don Soboleski1,2, S. Symons1, L. K. Davidson3, M. A. Ashworth3 and Paul Babyn2

1 Department of Diagnostic Radiology, Kingston General Hospital, Hotel Dieu Hospital, Queen's University, 76 Stuart St., Kingston, Ontario, K7L 2V7 Canada.
2 Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, Ontario, M5G 1X8 Canada.
3 Department of Surgery, Division of Orthopedics, Kingston General Hospital, Hotel Dieu Hospital, Queen's University, Kingston, Ontario, K7L 2V7 Canada.



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  		Fig. 1A. —4-year-old boy with fracture of distal radius. Oblique radiograph reveals transverse diametaphyseal fracture line (solid arrows). Note torus fracture of distal ulna (open arrow).

 


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  		Fig. 1B. —4-year-old boy with fracture of distal radius. Radiograph obtained 3 weeks after A shows increase in bone density (sclerosis) at fracture margins (arrows).

 


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  		Fig. 2A. —11-year-old girl with fracture of mid radius. Anteroposterior radiograph shows periosteal new bone (arrows) separated from underlying cortex by thin radiolucent line.

 


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  		Fig. 2B. —11-year-old girl with fracture of mid radius. Radiograph obtained 10.5 months after A reveals incorporation of periosteal new bone and callus into adjacent cortex (arrows) with bridging across fracture margins.

 


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  		Fig. 3A. —8-year-old boy with fracture of mid radius. Anteroposterior radiograph shows low-density periosteal new bone and slightly higher density callus separated from cortex and focal bump at fracture site (arrows).

 


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  		Fig. 3B. —8-year-old boy with fracture of mid radius. Radiograph obtained 7 weeks after A shows remodeling of fracture with loss of focal bump and increase in obtuse angle of new bone with cortex (arrow).

 


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  		Fig. 4. —Graph shows periosteal reaction evident ([UNK]) on all radiographs 4 weeks after injury. Note steady rise in periosteal new bone incorporation in cortex ([UNK]) 6 weeks after injury. Also note periosteal new bone separable from cortex ([UNK]).

 


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  		Fig. 5. —Graph shows most fractures have sclerosis ([UNK]) at fracture margins between 4 and 6 weeks. Also note fractures with widened gap ([UNK]).

 


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  		Fig. 6. —Image shows timetable for radiographic features of healing in children with fracture of the radius or ulna.

 

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