ACR Codes: 4.4
Derived from the latin word "Tori" meaning swelling or protuberance, the "torus" or cortical buckle fracture is a very common fracture involving the distal third of the radius in children. It usually results from a fall on an outstretched hand/wrist, resulting in a cortical kinking or buckling which may assume a vast array of configurations. Because children have softer bones, an incomplete fracture occurs, in which one side of the bone buckles upon itself without disrupting the other side. Therefore, one hallmark of the torus fracture is that it is frequently only well visualized in one radiographic projection; this applies especially to buckle fractures of the posterior/dorsal surface of the distal radial metaphysis, which are often only seen on a well-positioned lateral view.
Torus fractures in children may take the form of Collesâ€™ fracture (posterior cortical buckling with dorsal angulation of the distal radial fragment) or Smithâ€™s fracture (anterior cortical buckling with volar angulation of the distal radial fragment) â€śequivalents.â€ť
Treatment of torus fractures is by casting for a short duration (usually about three weeks) since these injuries usually heal much more quickly than the similar greenstick fractures.
Reference(s): Swischuk L. Emergency Imaging of the Acutely Ill or Injured Child. Lippincott Williams & Wilkins, Philadelphia, PA: 2000, pp. 349-352.