Buckle (Torus) Fracture of the Wrist

Description

A buckle (or torus) fracture is the gentlest kind of break: instead of cracking all the way through, the bone compresses and crumples on one side, like the dented end of a soda can. It happens near the wrist after a fall onto an outstretched hand and is very common and very stable.

How it happens (the mechanism)

Young bone is more flexible and porous than adult bone, so under the lengthwise load of a fall it tends to buckle rather than snap — the way a green twig crimps instead of breaking clean. The compressed side wrinkles outward while the rest of the bone stays intact, which is exactly why a buckle fracture is so stable and dependable.

Symptoms

Pain and tenderness near the wrist with mild swelling, but usually no obvious deformity. Children can often still move the hand.

Doctor examination and imaging

The doctor confirms tenderness over the bone, and X-rays show the small wrinkle or bulge in the bone’s surface.

Treatment

Because they are so stable, most buckle fractures do well in a removable wrist splint or a short cast, simply for comfort, for about three to four weeks. They rarely need setting and essentially never need surgery; research shows removable splints work as well as casts for true buckle fractures, with the convenience of removing the splint to bathe.

Recovery and long-term outlook

Buckle fractures heal reliably and completely, with no lasting effects. Many do not even require repeat X-rays.

When to call the doctor

Call if pain is severe or worsening, your child will not use the arm at all, the area becomes very swollen, red, or warm, your child develops a fever, or things are not improving as expected.

Learn more

OrthoInfo (AAOS) — Forearm Fractures in Children: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.