{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:10:08Z","timestamp":1756285808999,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,20]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Puckering of the skin following a fracture is a rare sign which can result in skin necrosis if the fracture is not urgently reduced. Skin puckering is associated with humeral, tibia and clavicular fractures. We present a case of a 79-year-old woman who fell on to her outstretched hand sustaining a right radial fracture with obvious skin puckering. Following X-rays, local anaesthetic was given and the skin was reduced, the fracture manipulated and a full cast applied. The patient made a full recovery. To our knowledge, this is the first reported case of the pucker sign in an adult radial fracture.<\/jats:p>","DOI":"10.1136\/bcr-2018-228046","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:10:44Z","timestamp":1678752644000},"page":"e228046","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Pucker sign in an adult distal radial fracture"],"prefix":"10.1136","volume":"12","author":[{"given":"Mazin","family":"Al-salihy","sequence":"first","affiliation":[{"name":"Trauma and Orthopaedics, University Hospital of South Manchester NHS Foundation Trust, Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Ross","sequence":"additional","affiliation":[{"name":"Medicine, University of Manchester, Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,4,3]]},"reference":[{"key":"2025082701533871000_12.4.e228046.1","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1111\/ped.12990","article-title":"Pucker sign in a distal radial fracture","volume":"58","author":"Nomura","year":"2016","journal-title":"Pediatr Int"},{"key":"2025082701533871000_12.4.e228046.2","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1308\/003588408X321701","article-title":"Skin puckering as a sign of humeral neck fracture","volume":"90","author":"Alshryda","year":"2008","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082701533871000_12.4.e228046.3","doi-asserted-by":"crossref","first-page":"e99","DOI":"10.1016\/j.jemermed.2012.11.011","article-title":"Skin dimpling after a closed proximal humerus fracture","volume":"45","author":"Aneja","year":"2013","journal-title":"J Emerg Med"},{"key":"2025082701533871000_12.4.e228046.4","doi-asserted-by":"crossref","first-page":"115","DOI":"10.17140\/EMOJ-1-118","article-title":"The Pucker sign: a rare finding associated with humeral neck fracture","volume":"1","author":"Mellick","year":"2016","journal-title":"Emergency Medicine - Open Journal"},{"key":"2025082701533871000_12.4.e228046.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2012.02.001"},{"key":"2025082701533871000_12.4.e228046.6","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.ajem.2017.08.036","article-title":"The pucker sign in children with an upper limb fracture: A case-series","volume":"36","author":"Nomura","year":"2018","journal-title":"Am J Emerg Med"},{"key":"2025082701533871000_12.4.e228046.7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s11751-013-0162-y","article-title":"Pucker sign in proximal humeral fractures: implications on management","volume":"8","author":"Jindal","year":"2013","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"2025082701533871000_12.4.e228046.8","doi-asserted-by":"crossref","first-page":"e229","DOI":"10.1097\/BPO.0000000000000893","article-title":"The effect of the Pucker sign on outcomes of type III extension supracondylar fractures in children","volume":"37","author":"Smuin","year":"2017","journal-title":"J Pediatr Orthop"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228046","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:53:48Z","timestamp":1756284828000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":8,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4,3]]},"published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1136\/bcr-2018-228046"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228046","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}