Lead Pipe Fracture | Radiology Signs

Answer:
Lead Pipe Fracture is a descriptive term for a pediatric long bone fracture (classically the distal radius/forearm) that combines a greenstick fracture on the tension side with a torus (buckle) fracture on the compression side of the same bone. This injury is typically seen in children due to the relative flexibility and plasticity of their bones, which allows for incomplete fracture patterns under combined compressive and bending forces.

Why is it called so?

The term “Lead Pipe Fracture” is derived from the analogy of a soft lead pipe bent under force — it cracks on the outer (tension) side while bulging on the inner (compression) side, rather than snapping completely, reflecting the mixed pattern of incomplete fractures. This is a descriptive term used mainly in musculoskeletal imaging teaching references rather than in indexed primary research literature.

Pathophysiology

The pattern develops when a child’s bone is subjected to longitudinal compression and bending forces, leading to a buckle (torus) fracture on the compressed side and a greenstick fracture (incomplete break with cortical disruption on the tension side, intact cortex on the compression side) on the opposite side. This combination results in a bone that is partially bent and partially fractured, mimicking the deformity seen in a bent lead pipe.

Alternative names:
None

Other associated named signs:
Greenstick fracture, Torus (buckle) fracture, bowing (plastic deformation) fracture

References

1. Stoller DW, Brody GA. The wrist and hand. In: Stoller DW, ed. Magnetic Resonance Imaging in Orthopaedics and Sports Medicine. 2nd ed. Lippincott-Raven; 1997. (Standard musculoskeletal imaging reference describing the lead pipe fracture pattern; no indexed journal article specifically established this term.)