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Bunk Bed Fracture
Case Detail
| Anatomy: Musculoskeletal |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Trauma |
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| Created: over 3 years ago |
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| Updated: over 3 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
CR
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Activities:  PDF  ImageJA |
History
3 year old male with foot pain; jumped off bed 2 days prior.
Case Images
Diagnosis
Bunk bed fracture of 1st metatarsal.
Findings
XR – Nondisplaced medially impacted fracture of the base of the first metatarsal.
Discussion
Bunk bed fractures are a common injury in children but often overlooked. These fractures are produced as a result of landing on a plantar flexed foot, usually from a fall or a jump.
Plantar flexion leads to wedging of the first metatarsal between the medial cuneiform and second metatarsal. This is accentuated by the normal ventral concavity of the proximal first metatarsal and the horizontal obliquity of the medial cuneiform. Avulsion forces by the tibialis anterior and peroneus longus tendons may also contribute to bunk bed fractures.
The bunk bed fracture is associated with ligamentous injury at the tarsometarsal junction and is considered a pediatric variant of the Lisfranc injury.
Reference
Johnson GF. Pediatric Lisfranc Injury: “Bunk Bed” Fracture. AJR 1981; 137:1041-1044.