Torus fractures (also known as buckle fractures) are incomplete fractures of the shaft of a long bone that is characterised by bulging of the cortex. They usually result from trabecular compression from an axial loading force (along long axis of bone). Usually seen in children, frequently involving the distal radial metaphysis.
Cortical buckle fractures occur when there is axial loading of a long bone. This most commonly occurs at the distal radius following a fall on an outstretched arm: the force is transmitted from carpus to the distal radius and the point of least resistance fractures - usually the dorsal cortex of the distal radius.
- distinct fracture lines are not seen
- subtle deformity or buckle of the cortex may be evident
- in some cases, angulation is the only diagnostic clue
Treatment and prognosis
They are self limiting and do not require operative intervention. Sometimes a cast may be applied, but often a splint is all that is required with period of rest and immobilisation.
The term torus is derived from the Latin word tori which means protuberance.
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- 2. Jadhav SP, Swischuk LE. Commonly missed subtle skeletal injuries in children: a pictorial review. Emerg Radiol. 2008;15 (6): 391-8. doi:10.1007/s10140-008-0733-2 - Pubmed citation
- 3. Plint AC, Perry JJ, Tsang JL. Pediatric wrist buckle fractures. Should we just splint and go? CJEM. 2004;6 (6): 397-401. CJEM (link) - Pubmed citation
- 4. Hernandez JA, Swischuk LE, Yngve DA et-al. The angled buckle fracture in pediatrics: a frequently missed fracture. Emerg Radiol. 2003;10 (2): 71-5. doi:10.1007/s10140-003-0288-1 - Pubmed citation
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Synonyms & Alternative Spellings
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|Cortical buckle fracture||✗|