Torus fractures, (also known as buckle fractures), are very commonly seen in children. Children have softer bones, thus, one side of the affected bone tends to buckle upon itself without disruption of the other side; it is also known as an incomplete fracture. The torus fracture usually occurs in children and teens because their bones are bendable, contrasting adults, whose brittle bones tend to break.
The word ‘torus’ has been derived from the Latin word ‘tori’ which means bulge or protrusion. Children get a torus fracture by falling on an outstretched hand. The treatment of the fracture is by casting for a short duration of time, typically 3 to 4 weeks.
\Torus fracture of the distal metaphysis of the bones of the forearm, i.e. the radius and the ulna is most common type of fracture in children. Medically, the power of indirect violence of a fall on an outstretched hand buckles the dorsal cortex; however, the volar cortex stays undamaged.
By and large, the affected area is the distal third of the forearm and involves the radius as well as the ulna.
A torus fracture is distinctive to babies and infants, given the flexible nature of the bone due to immature mineralization. When a compressive force gets exerted on a tubular bone’s long axis, the stress causes buckling. The cause is invariably a fall on the outstretched arm.
Symptoms And Diagnosis Of Buckle Fracture
A torus fracture is manifested as:
- A painful, swollen wrist.
- Redness and tenderness.
- Swelling and inflammation causing stiffness and reduced movement of the wrist joint.
- Babies and toddlers will cry inconsolably; older kids will be very protective about the fractured part.
- The X-ray will reveal signs of buckling. In such cases, it is always wise to film the wrist as well as the elbow to rule out dislocation of the proximal and distal radio-ulnar joints.
- Sometimes, radiographic signs may not be present on the first X-ray and the diagnosis needs to be made on the basis of the clinical findings and the presenting symptoms. A second set of X-ray is necessary after 2 weeks of the trauma.
- The X-ray shows a certain cortical bulge usually at the metaphysis, 4 centimeters from the distal growth plate. While a torus fracture can occur in any long bone, the distal aspect of the radius is the commonest site.
Treatment Of Torus Fracture
The treatment regimen to manage a torus fracture comprises of a short arm cast for 3 to 4 weeks to make the person comfortable and to avert further injury. By and large, a torus fracture does not displace further, and is generally managed by using a well-fitting immobilizing cast for about 4 weeks.
The chief aim of the immobilizing cast is to allay the pain and discomfort. Experts also state that a cast that crosses the elbow is very important in order to prevent an angulation deformity of the bones during the phase of healing.
Due to the compressive forces on the radius and the closeness of the two bones, often the ulna is involved as well. On the other hand, some doctors advice splints. They say that removable splints have better outcomes in children with torus fractures.