A torus fracture, commonly referred to as a buckle fracture, is a frequent type of bone injury seen in children. This injury is characterized by a compression of the bone that causes it to bulge or “buckle” outward, without breaking the bone completely into two separate pieces. Because the outer layer of the bone remains intact, this injury is inherently stable and considered less severe than a complete fracture.
The Mechanism of a Torus Fracture
This particular type of injury occurs because a child’s bone tissue is softer and more flexible than an adult’s, making it more prone to bending or crushing under pressure. The fracture typically results from an axial compression force, such as a child falling onto an outstretched hand. This force travels lengthwise through the long bone, causing the bone to compress on itself.
The injury usually affects the metaphysis, the wider section of the bone near the growth plate. Instead of snapping, the soft bone tissue buckles, creating a small, visible kink or ridge. The intact cortical bone, the dense outer layer, is what maintains the stability of the injury.
Identifying Symptoms
The signs of a torus fracture are often localized, prompting a guardian to seek medical attention. The most common complaint is immediate, localized pain at the site of the injury. The injured area will also exhibit tenderness when touched, which helps pinpoint the location of the fracture.
Swelling is typically present, though it is often mild to moderate and less pronounced than with a full bone break. The child may also show a reluctance or an inability to use the injured limb normally due to the pain. While a noticeable deformity is possible, it is often minimal because the bone remains largely in alignment.
Medical Confirmation and Management
A diagnosis of a torus fracture is primarily confirmed through the use of X-rays. These images visualize the bone structure, clearly showing the characteristic bulge or buckling of the cortex.
Management focuses on providing comfort and protecting the injury site to allow for proper healing. Due to the inherent stability of the fracture, non-surgical treatment is standard, and surgical intervention is almost never required. The common treatment involves immobilizing the limb, typically with a removable wrist splint, a soft cast, or a supportive brace.
The use of a rigid, full-circumference cast is now often avoided, as removable supports have been shown to be equally effective while improving patient comfort. This immobilization period helps to relieve pain and prevents further stress on the healing bone. Once the diagnosis is confirmed, the patient is often discharged from the emergency department with instructions for home care.
Expected Recovery and Follow-Up Care
A full recovery is the expected outcome for nearly all patients. Immobilization in a splint or brace is typically required for about three weeks to allow the bone to heal adequately. The removable nature of modern supports allows for better hygiene and comfort during this period.
After the immobilization device is removed, the child may experience some mild stiffness or aching at the wrist, which is a normal part of the healing process. Patients are typically advised to avoid high-impact or contact sports for several weeks following the removal of the support, with a full return to activity generally occurring within four to eight weeks from the injury date. Long-term complications are extremely rare, and the child’s bone is expected to regain full strength and function.
Follow-up care is often minimal or unnecessary because the injury is so stable, meaning repeat X-rays or specialist orthopedic appointments are rarely needed once the initial diagnosis is made. Parents are advised to monitor for signs like persistent swelling, pain that does not improve, or a continued refusal to use the limb, which would warrant another consultation with a healthcare provider.