What is a buckle (torus) fracture in children?

What is a buckle (torus) fracture in children?

• A. An incomplete fracture with cortical buckling due to bending
• B. A complete fracture with displacement
• C. A fracture through the growth plate
• D. A greenstick fracture with angulation

Answer: (A)

Buckle fractures occur in children when the cortex buckles inward under bending or compressive stress without a complete break, so the bone remains in one piece. This incomplete fracture reflects the softer, more pliable pediatric bone and the thick periosteum that can cushion the impact. On X-ray you often see a subtle bending or bulge of the cortex rather than a clean fracture line, and there is little to no displacement. It’s different from a complete fracture with displacement, which would show a full break and misalignment; it isn’t a growth plate fracture, which involves the physis; and it isn’t a greenstick fracture with angulation, where there is a crack through one cortex with bending and some displacement. Buckle fractures heal very well with immobilization.

Buckle fractures occur in children when the cortex buckles inward under bending or compressive stress without a complete break, so the bone remains in one piece. This incomplete fracture reflects the softer, more pliable pediatric bone and the thick periosteum that can cushion the impact. On X-ray you often see a subtle bending or bulge of the cortex rather than a clean fracture line, and there is little to no displacement. It’s different from a complete fracture with displacement, which would show a full break and misalignment; it isn’t a growth plate fracture, which involves the physis; and it isn’t a greenstick fracture with angulation, where there is a crack through one cortex with bending and some displacement. Buckle fractures heal very well with immobilization.