October 24, 2009

Buckle (Torus) Fracture of the Distal Forearm


Radiographs of the wrist of an 11-year-old girl following a fall show a subtle buckle fracture of the distal radius (arrows), clearly visible on the lateral view.

Facts:
  • Common locations = wrist and ankle
  • 2nd most common fractures in infancy and childhood after epiphyseal-metaphyseal fractures
  • Falls on outstretched extremity

Imaging Features:
  • Rule -- cortex of a normal bone is always smooth and gently curving (always trace each cortex individually in all available views)
  • Buckle fractures can be a focal cortical slope, angle, kink, bump or break
  • Usually clearly visible on one view than another
  • When healed, sclerosis develops along the fracture line
References:

1. Swischuk LE. Emergency imaging of the acutely ill or injured child. 4th ed, 2000.

2. Swischuk LE. Imaging of the newborn, infant, and young child. 5th ed, 2004.

2 comments:

xiu said...

What should I do? if i see Pt with buckle fracture in ER.

Rathachai Kaewlai, M.D. said...

Buckle fractures are treated with casting or splint placement. These fractures heal uniformly without sequelae, so there is no or little need for "radiographic" follow up (may still need clinical follow up).

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