torusfraktur

Torusfraktur, commonly known in English as a buckle fracture, is a pediatric fracture characterized by buckling or compression of the cortex of a long bone under axial load, with no complete fracture line. It most often involves the distal radius and occurs in children because their bones are more pliable.

Pathophysiology and presentation: The injury results from a fall or direct impact that compresses the bone, causing one side of the cortex to buckle inward while the opposite cortex remains intact. The periosteum is usually preserved, and there is little to no displacement. Patients often present with localized tenderness, swelling, and limited use of the limb, typically after a fall onto an outstretched hand.

Imaging: Plain radiographs show a cortical buckle or bulging on the compression side, without a complete fracture line. Sometimes findings are subtle, and the cortex appears slightly broadened rather than fractured. In uncertain cases, a short-interval radiographic recheck can help confirm stability.

Management: Torusfrakturs are generally treated with immobilization rather than reduction. A short-arm cast is commonly used for about 3 weeks (occasionally up to 4 weeks), with analgesia as needed. No unique reduction is required because the bone is stable and the fracture is nondisplaced. Return to normal activities is guided by cast removal and symptom resolution.

Prognosis: Healing is rapid and usually complete, with a very good prognosis and no lasting deformity. Complications are rare but can include misdiagnosis or premature return to activity; follow-up is typically straightforward if symptoms persist or if radiographs fail to improve.