965 children were in this study, which showed equivalent results for pain scores, function and complications between the treatments. This study fairly allocated children (through randomisation) to either splint and routine follow-up, or a bandage and no follow-up. The study was conducted throughout the UK in 21 emergency departments. However, in 2022 the largest and highest quality treatment study was published about this injury in the Lancet medical journal - called the FORCE Study (see infographic in images). There is no established 'standard' treatment for buckle fractures. The bone may have a slight angulation.The buckling of cortical bone, which may appear as a small bulge or protuberance in the radius or ulna.The diagnosis of a torus fracture is made from both anterior/posterior and lateral projections. Diagnosis īuckle fracturs can be identified by performing a radiograph. Such orthopaedic injuries are distinctive in children as their bones are softer and in a dynamic state of bone growth and development, with a higher collagen to bone ratio so incomplete fractures such as the buckle fracture are a more common occurrence. As aforementioned, the most common buckle fracture is of the distal radius in the forearm, which typically originates from a Fall Onto an Outstretched Hand ( FOOSH). Physical activities or sports such as bike riding or climbing increase the associated risk for buckle fractures in the potential event of a collision or fall. As with other fractures, the site of fracture may be tender to touch and cause a sharp pain if pressure is exerted on the injured area.
This mechanism is analogous to the crumple zones in cars.
As the bone buckles (or crushes), instead of breaking, they are a stable injury as there is no displacement of the bone. Torus fractures are low risk and may cause acute pain. The word "torus" originates from the Latin word "protuberance." A radiograph image of a torus (buckle) fracture Simplified diagram of a buckle fracture Signs and symptoms The compressive force is provided by the trabeculae and is longitudinal to the axis of the long bone, meaning that the fracture itself is orthogonal to that axis. As the bulge is only on one side of the bone, this injury can be classified as an incomplete fracture. It is a common occurrence following a fall, as the wrist absorbs most of the impact and compresses the bony cortex on one side and remains intact on the other, creating a bulging effect. A Torus fracture, also known as a buckle fracture is the most common fracture in children.
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