Torus fracture

Background

• Compressive force leads to bulging of the periosteum/cortex
• Also known as buckle fracture
• Often occur at the end of long bones

Clinical Features

• Frequently involves distal radial metaphysis
• Minimal visual deformity
• Soft tissue swelling and point tenderness at injury

Differential Diagnosis

• Greenstick fracture
• Corner fracture (Bucket Handle)

Evaluation

Compression of the cortex and the metadiaphyseal junction consistent with a torus fracture

• Soft tissue swelling and point tenderness
• Visible deformity is unusual

Management

• "A simple volar slab or velcro wrist splint or "soft cast" was better than a rigid cast for pediatric torus fractures of the forearm."
• Splint in position of function

Disposition

• Follow up with pediatrician in 1 week

See Also

• Fractures and dislocations (peds)
• Fractures

References

• Geiderman JM, Katz D: General Principles of Orthopedic Injuries, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 46:p 473-474.
• Hopkins-Mann C, Ogunnaike-joseph D, Moro-Sutherland D: Musculoskeletal Disorders in Children, in Tintinalli JE, Stapczynski JS, Ma OJ, et al (eds): Tintinalli’s Emergency Medicine, ed 7. New York, The McGraw-Hill Companies Inc., 2011, (Ch) 133
• Koelink, Eric, et al. “Primary Care Physician Follow-up of Distal Radius Buckle Fractures.” Pediatrics, vol. 137, no. 1, 2015, doi:10.1542/peds.2015-2262.