A buckle fracture, also known as a torus fracture, is a common bone injury, particularly prevalent among children. It is a type of incomplete fracture where the bone compresses or bulges on one side rather than breaking completely through.
Understanding Buckle Fractures
A buckle fracture is a unique type of bone injury where the outer layer of the bone, known as the cortex, buckles or folds due to a compression force. Unlike a complete fracture where the bone breaks into two or more pieces, a buckle fracture involves only a partial break, often leaving the opposite side of the bone intact.
Buckle fractures occur in the long bones, especially the radius and ulna in the forearm near the wrist, and are common in children. Children’s bones possess a higher degree of flexibility and porosity compared to adult bones, making them more susceptible to this type of compression injury rather than a full break. The term “torus” originates from Latin, meaning “protuberance” or “swelling,” aptly describing the characteristic bulge seen in these fractures.
Identifying a Buckle Fracture
Buckle fractures result from axial loading, a force applied along the length of the bone. The most frequent cause is a fall onto an outstretched hand (FOOSH), where the impact travels up the arm and compresses the bones in the forearm. This mechanism is common in active children engaging in sports or play.
Signs and symptoms of a buckle fracture are less severe than those of a complete break. Individuals experience localized pain, swelling, and tenderness around the injured area. There may also be some difficulty or reluctance to move the affected limb. A characteristic of buckle fractures is minimal or absent visible deformity, as the bone does not displace significantly.
Medical Care for Buckle Fractures
Diagnosing a buckle fracture involves a physical examination and imaging studies. A healthcare professional will assess the injured area for pain, swelling, and tenderness. X-rays are the standard diagnostic tool, which will reveal the characteristic “buckle” or bulge in the bone’s outer layer, confirming the diagnosis.
Treatment for buckle fractures is straightforward and non-surgical, given their stable nature. The primary goal of treatment is to immobilize the injured bone to allow for proper healing and to manage pain. This is achieved using a splint or a lightweight cast, which stabilizes the bone while allowing some flexibility. In some cases, a removable brace may be used, offering convenience for bathing and gradual reintroduction of movement.
Healing and Recovery
Buckle fractures heal well and relatively quickly, especially in children. The immobilization period lasts for about three to four weeks, during which the bone naturally repairs itself. After the splint or cast is removed, some stiffness or soreness in the wrist or forearm is common initially.
Follow-up appointments are important to ensure the bone is healing correctly and to guide the gradual return to normal activities. Most children can resume full activities within four to six weeks, with activities that risk re-injury being avoided until symptoms have completely resolved. Buckle fractures have an excellent prognosis, and long-term complications or future re-fracture risks are uncommon.