Torus Fracture (a.k.a. Buckle Fracture)

Key Points:

--Torus is derived from Latin (tori) meaning ‘a swelling.‘

--Damage to cortex on compression side, 2-3 cm proximal to physis.

--Torus fractures of distal metaphysis of radius/ulna are the most common forearm fracture in young children.

--Impact of fall on outstretched hand (FOOSH) injury crumples the dorsal cortex, but the volar cortex remains intact; distal fragment is angulated dorsally.

--Deformity should not occur in torus fracture because the periosteum and cortex are intact on the side of the bone opposite to fracture.

Treatment:

--Short arm cast for 3 weeks for comfort and to prevent further injury.

--BEFORE CAST/SPLINT: Double check the X-Ray. If the fracture is not on compression side, then the patient has greenstick fracture, which may proceed to deform in the cast.

Reference(s): Wheeless’ Textbook of Orthopedics, Northwestern University Emergency Medicine Residency Orthopedic Teaching Files (picture)

Submitted by K. Sullivan.