From the Guidelines
The recommended management for a torus (buckle) fracture across the distal radial metaphysis is immobilization with a removable splint for 3-4 weeks. This type of fracture is stable and has an excellent prognosis without the need for reduction or surgical intervention. A removable splint is preferred over a cast as it allows for better functionality, hygiene, and comfort while still providing adequate support for healing, as suggested by the use of removable splints for minimally displaced distal radius fractures 1. The splint can be removed for bathing and gentle range of motion exercises, which helps prevent stiffness. Pain management typically involves acetaminophen or ibuprofen as needed. Clinical follow-up should occur at 3-4 weeks to confirm healing, though radiographic follow-up is often unnecessary unless symptoms persist. Torus fractures heal well because they involve compression of cancellous bone at the metaphysis where blood supply is abundant, promoting rapid healing. Some key points to consider in the management of torus fractures include:
- Immobilization with a removable splint for 3-4 weeks
- Pain management with acetaminophen or ibuprofen as needed
- Clinical follow-up at 3-4 weeks to confirm healing
- Radiographic follow-up only if symptoms persist
- Full recovery with return to normal activities is expected within 4-6 weeks, though contact sports should be avoided until complete healing is confirmed.
From the Research
Management of Torus Fractures
The management of Torus (buckle) fractures across the distal radial metaphysis involves several key aspects, including:
- Immobilization method and duration
- Clinical follow-up
- Radiological follow-up
- Use of diagnostic ultrasound
Recommended Management
According to the available evidence, the recommended management for Torus fractures includes:
- Use of a removable splint, such as a Futura-type wrist splint, for 3 weeks 2, 3, 4
- No need for fracture clinic follow-up or repeat radiological imaging once patients are given adequate information at the time of diagnosis 2, 5
- Soft-bandage and immediate discharge approach, without specialist follow-up 5
Immobilization Methods
Different immobilization methods have been compared, including:
- Splint: associated with lower complication rates, fewer hospital admissions, and less need for radiological imaging 4
- Short arm circular plaster: may be used, but is associated with higher complication rates and more need for radiological imaging 4
- Soft bandage: may be used, but is associated with higher complication rates and more need for radiological imaging 4
Clinical and Radiological Follow-up
The evidence suggests that: