Remodel·Atlas
Pediatric fracture remodeling simulator

Estimate remodeling potential, healing phases, and follow-up imaging for pediatric long-bone fractures.

Enter your child's age, the involved bone, fracture location, and initial angulation. The tool combines published growth-potential rules (Naik 2021; POSNA; Orthobullets; OTA teaching slides) with bone-specific physeal growth rates to project how the deformity is expected to straighten — and when to image to verify.

Educational tool — not clinical advice. Estimates are based on published averages and simplified heuristics; they cannot replace evaluation by a pediatric orthopedic surgeon. Always defer to the treating clinician's plan and imaging schedule.

Patient & fracture inputs

Step 1
years
months · 1y 6m
Metaphyseal fractures sit closer to the physis and remodel best.
Sagittal = procurvatum / recurvatum (flexion-extension). Coronal = varus / valgus.
Measured from the fracture apex on the post-injury film. Measure from an X-ray →
Cm of fragment overlap (bayonet apposition). Leave 0 if end-to-end. Overgrowth credit is applied automatically.

Remodeling outlook

Step 2 · Estimate

Projected angulation over 24 months

Wolff & Hueter-Volkmann projection

Asymptotic decay model: physeal realignment (≈75% of correction) plus appositional cortical drift (≈25%). Rate is scaled by physeal growth (mm/yr) and years of growth remaining. Reference young-child distal-radius remodeling rate ≈ 2.5°/month (Friberg 1979).

Contribution breakdown

Multiplicative model

Healing & remodeling phases

RCH timeline

Bayonet & limb-length forecast

Shortening + overgrowth

Recommended follow-up X-ray schedule

Imaging milestones

Bhatia & Housden (PMC2656806) showed that beyond the 2-week post-cast film, additional in-cast radiographs rarely change management — so this schedule front-loads imaging around reduction and pushes long-term films to remodeling milestones.

Measure angulation from an X-ray image

Manual on-image measurement
Educational use only. This tool helps you measure an angle on an uploaded image, but it cannot replace formal radiographic measurement. For clinical decisions, defer to your pediatric orthopedic surgeon and CE/FDA-cleared measurement tools.
JPG, PNG, or WEBP. Use AP or lateral view.
Proximal fragment axis (points 1 + 2)
Distal fragment axis (points 3 + 4)

Upload an X-ray to begin

Acceptable angulation by bone & age

Reference cards · click your bone above to highlight

Evidence & references

  1. Naik P. Remodelling in Children's Fractures and Limits of Acceptability. Indian J Orthop, 2021. (Acceptable-angulation tables across bones and ages.)
  2. Royal Children's Hospital Melbourne. Fracture education — Healing phases. (Inflammatory → reparative → remodeling timeline.)
  3. POSNA. Pediatric humeral shaft fractures. (Acceptable angulation in pediatric humerus shaft.)
  4. Orthobullets. Femoral shaft fractures — pediatric. (Coronal/sagittal goals, overgrowth, treatment by age.)
  5. Orthobullets. Tibial shaft fractures — pediatric. (5–10° angulation thresholds.)
  6. Orthobullets. Both-bone forearm fracture — pediatric. (Age-stratified angulation & rotation tolerances.)
  7. OTA Pediatric Teaching Series. Pediatric forearm & wrist fractures. (Remodeling potential by site & years of growth left.)
  8. OTA Pediatric Teaching Series. Tibia & fibula fractures in the pediatric patient.
  9. Bhatia M, Housden P. Are frequent radiographs necessary in closed forearm and tibial fractures in children?. J Child Orthop, 2008.
  10. Stephens MM, Hsu LCS, Leong JCY. Leg-length discrepancy after femoral shaft fracture in children. J Bone Joint Surg Br, 1989. (Overgrowth ranges used for the bayonet/limb-length forecast.)
  11. Park H, Kim HW (overgrowth literature review). Femoral fracture overgrowth. Clin Orthop Surg, 2012.
  12. Pritchett JW (lower-limb growth contributions). Lower-limb growth: how predictable are predictions? J Child Orthop, 2008. (Physeal growth-rate values used here.)

Algorithm: remodeling % = base(growth remaining) × site multiplier × plane-of-motion multiplier × magnitude multiplier, capped at 98%. Time-to-correction uses an exponential decay calibrated to ~2.5°/month in the distal radius of children <10y.