You are seeing a pair of siblings that crashed into each other while jousting on their bikes. They were wearing helmets but both sustained forearm injuries. Both have swollen, tender forearms and you get X-Rays. And, no, there is not a BOGO discount.
Both patients have forearm fractures. Patient A has a buckle, or torus fracture. This occurs when the bone is compressed and the cortex buckles, often when the child falls on an outstretched hand (FOOSH). Patient B’s fracture is notably more angulated and represents diaphyseal fractures of both the radius and ulna with apex-volar angulation. It is also a complete fracture, since the cortex has been broken through.
Patient A has a stable injury that requires splinting and pain relief. A volar or sugartong splint will suffice.