bucklefraktur

Bucklefraktur, known in English as a buckle fracture or torus fracture, is a stable pediatric fracture characterized by buckling of the cortical bone without a complete cortical break. It is an incomplete fracture in which the cortex on the compression side buckles while the opposite cortex remains intact. The term bucklefraktur is used in some German-language medical literature to describe this injury.

Most commonly, bucklefrakturen affect the distal radius, though they can occur in other long bones such as the distal tibia. They typically result from axial loading after a fall, for example onto an outstretched hand. The bones of children are more pliable, which predisposes them to this type of injury.

Radiographic features can be subtle on initial films. The hallmark is a buckled or raised metaphyseal cortex on the compression side with no significant displacement and preserved alignment. The periosteum is usually intact. If clinical suspicion remains high but radiographs are negative, repeat imaging after 1–2 weeks may reveal the characteristic finding as the bone begins to remodel.

Management is conservative. Treatment usually consists of immobilization in a short-arm cast or splint for about three weeks (adjusted for age and healing), along with analgesia as needed. Return to full activities is guided by pain relief and radiographic healing. The prognosis is excellent, with most fractures healing without deformity and without the need for surgical intervention.

Differential diagnoses include greenstick fractures, where one cortex is broken, and plastic deformation. Complications are rare but may include missed growth plate injury if not evaluated appropriately.