A 7-year-old boy presented with right arm pain after falling on an outstretched arm while playing. Examination revealed tenderness over the distal forearm with full range of motion of the fingers and intact neurovascular status. X-ray showed a non-displaced torus fracture of the distal radius. Treatment consists of splinting and a short arm cast for 3 weeks for comfort and prevention of further injury, with no reduction needed. Torus fractures are unique to children and occur when pediatric bone buckles rather than fully fracturing under axial loads.

2.  7 YOM presents with R
arm pain. Pt was playing
outside 30 minutes PTA
when he fell on an
outstretched R arm. No
head trauma or LOC. No
other injuries.
 T 98.7 HR 119 BP 109/64
RR 21
 Gen: WDWN, mild
distress
 MSK: Pt holds RUE very
still but has little TTP or
swelling on exam. Mild
TTP of distal forearm.
FROM of fingers of R
hand with active and
passive ROM. R hand
neurovascularly intact.

4. Arrow shows a non-displaced torus fracture at the metaphysealdiaphyseal junction of the distal radius with no articular or growth
plate involvement.

5.  Pain Control
 Treatment consists of splinting with Ortho follow up
in one wk, usually followed by a short arm cast for 3
wks for pt comfort and to prevent further injury. No
reduction necessary.

6.  Pediatric bone is more porous than adult bone, allowing it
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to bend, buckle, or deform, with actual fracture. Hence,
torus fx is unique to pediatric pts.
Also called a “Buckle” fracture
Most common location is distal radius.
Occur at the diaphyseal-metaphyseal junction, where the
transition from relatively porous to more dense bone
predisposes to local failure when exposed to an axial load.
It is important that x-ray be carefully examined to ascertain
that tension side is intact.
If fx is not on compression side then pt has greenstick fx,
not a torus fx, & fx may proceed to deform in the cast.

8.  Wheeless' Textbook of Orthopaedics. Torus Fracture /
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Platic Deformation.
Tintinalli's Emergency Medicine: A Comprehensive
Study Guide. Chapter 133: Musculoskeletal Disorders
in Children
http://www.feinberg.northwestern.edu/emergencyme
d/residency/ortho-teaching/pediatrics/case13/
http://en.wikipedia.org/wiki/Greenstick_fracture
http://medical-definitions.com/fracture/torusfracture.htm