Acute Plastic Bowing of the Forearm in Adults: A Report of Two Cases

Abstract

We report 2 adult cases where the diagnosis of acute plastic bowing of the forearm was either delayed or missed. In a 21-year-old man, ulnar bowing was missed and fixation was not performed because the patient had no limitation to his range of movement or pain. In a 24-year-old woman, the presentation of bowing in both the ulna and radius was delayed and corrective osteotomy was necessary for restoration of full range of movement. Prompt diagnosis enables manual reposition for easy restoration of full range of movement.

Bilateral Asymmetry of the Forearm Bones as Possible Evidence of Antemortem Trauma in the StW 573 Australopithecus Skeleton from Sterkfontein Member 2 (South Africa)

“…It presents as a distinct abnormal curvature of the limb bone diaphysis, with microfracturing on the concave side of the bow (e.g., Borden 1974Borden , 1975. Though rare, adult cases of TBF of the forearm bones have been documented and usually result from slow bending forces such as those caused by entrapment in rotating machines (e.g., Greene 1982;Simonian and Hanel 1996;Sclamberg et al 1998;Sen et al, 2004;Lefaivre et al 2007;Tada et al, 2008;Tianhao et al, 2014). However, most often, it is children between the ages of four and ten years that experience TBF (Vorlat and De Boeck 2003) as a result of falls onto outstretched, hyperextended hands (e.g., Borden 1974Borden , 1975Naga and Broadrick 1977;Crowe and Swischuk 1977;Aponte and Ghiatas 1989;Vorlat and De Boeck 2003;Musters and Colaris 2017).…”

Treatment of Plastic Deformation of the Forearm in Young Adults With Double-Level Osteotomies: Case Reports

“…Three patients had open reduction and plating of the ipsilateral fractured forearm bone, with either no treatment or closed reduction of the plastic deformation. 9,20,25 The one patient in this group who had limitations in pronation and supination had only partial reduction of their bowing deformity, as well as DRUJ instability after ulnar plating. 20 The other patient's bowing deformity was initially missed at the time of surgery, but full forearm rotation was noted after plating of the radial shaft fracture.…”

“…20 The other patient's bowing deformity was initially missed at the time of surgery, but full forearm rotation was noted after plating of the radial shaft fracture. 25 Because the patient had no limitations in motion, deformity correction was not pursued. One patient was treated with closed reduction, as well as intramedullary fixation with Ender's nails, and had full restoration of forearm motion.…”

A Case of Acute Plastic Deformation of the Forearm in a Medieval Hispano-Mudejar Skeleton (13–14th Centuries AD)

“…Cases of APD are only rarely presented in paleopathology studies, meaning that it is very important to have the contralateral side for adequate analysis [46]. The investigator’s unfamiliarity with this type of lesion may have contributed to such low scores in paleopathological studies [35].…”