2025 – PAGE 412 – ORTHOPEDICS AND SPORTS MEDICINE

TORUS FRACTURE (AKA BUCKLE FRACTURE)

In a torus fracture (AKA buckle fracture), compression of bone via longitudinal force causes a fracture on one side that’s usually associated with a protuberance, but has NO fracture or deformity on the other side. It also does NOT go through the growth plate. It’s not that serious and is common in children due to their soft bones.

IMAGE: www.pbrlinks.com/TORUS1
IMAGE: www.pbrlinks.com/TORUS2
IMAGE: www.pbrlinks.com/TORUS3 (copyright free)

GREENSTICK FRACTURE

Usually occurs at the diaphysis and occur from the bending of young, soft bone. They look like a partially broken stick with the break only on one side.

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DISTAL HUMERAL FRACTURES

Children can have neurovascular injury with distal humeral fractures, especially if there is any displacement of the bone, and it is supracondylar. These are associated with a posterior fat pad and can result in compartment syndrome. Pulses can be normal. Look for “more than expected pain.”

IMAGE: www.pbrlinks.com/DISTAL1

DISLOCATED SHOULDER

If an adolescent presents with a dislocated shoulder, anterior dislocation is MUCH more common than posterior. Obtain an AXILLARY view X-ray.

PEARL: If a prepubertal child presents with what looks like dislocated shoulder, it’s probably NOT A DISLOCATION. Less than 2% of dislocations are in kids < 10 years of age, so look closely for a FRACTURE.