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Buckle (Torus) Fractures of the Wrist

What are Buckle (Torus) Fractures?

Buckle fractures are injuries that occur to either the radius, ulna or both usually due to a fall in young children. Buckle fractures are NOT what most people think of when they think of a fracture or broken bone. The fracture does not go through the entire bone. Because of this, buckle fractures are very stable fractures, so we do not have to worry about them moving out of alignment. They also heal more quickly than a typical fracture.

Bones are like pipes in that the strongest portion of the bone is around the sides (called the cortex or cortices for plural). In a buckle fracture, one or two cortices are compressed during the fall resulting in very slight bending on one side, but the other side of the bone is not injured. As such, the bone is NOT broken into two pieces.

 

Arrows point to the buckle in the cortex. Notice that there is not a fracture line extending across the bone.

How are Buckle Fractures Treated?

Because buckle fractures are not complete fractures, they are very stable fractures and heal quickly. A cast is not usually necessary, and we typically treat these with a removable Velcro® wrist brace. The brace can be removed for bathing but should otherwise be worn at all times while the patient has pain. As the pain improves, the brace may be removed for sleeping and even swimming. It should be worn at all other times for a total of 3 to 4 weeks. At 3 to 4 weeks, the parent can give the child’s wrist a firm squeeze. If the patient does not have pain at that point, he or she may quit using the brace and resume normal activities.

What is the Long-Term Outcome?

Buckle fractures do not involve the growth plate, so there are no complications with a difference in the lengths of the forearms or with deformity. Buckle fractures do not put a patient at higher risk for another fracture in the future.