Treatment of Torus Fracture of the Left Distal Radius
A removable splint worn for 3 weeks is the recommended treatment for torus (buckle) fractures of the distal radius. 1, 2
Initial Management
- Torus fractures are stable, minimally displaced fractures that can be effectively managed with removable splints rather than traditional casts 1, 2
- The American Academy of Orthopaedic Surgeons (AAOS) specifically recommends removable splints as an appropriate option for treating minimally displaced distal radius fractures 1
- A "Futura-type" wrist splint has been shown to be equally effective as plaster casts in managing these fractures 3
Duration of Treatment
- The splint should be worn for approximately 3 weeks 1, 2
- Radiographic follow-up is recommended at approximately 3 weeks to confirm adequate healing 1
Follow-up Protocol
- Current evidence suggests that after initial diagnosis and proper patient education, there is no need for routine fracture clinic follow-up or repeat radiological imaging 2
- A final radiograph at the time of immobilization removal (around 3 weeks) is recommended to confirm adequate healing 1
Rehabilitation Considerations
- Active finger motion exercises should be performed following diagnosis to prevent stiffness, which is one of the most functionally disabling adverse effects of distal radius fractures 1
- Finger motion does not adversely affect adequately stabilized distal radius fractures in terms of reduction or healing 1
- Early wrist motion is not routinely necessary following stable fracture fixation 1
Special Considerations and Potential Complications
- Monitor for potential complications such as skin irritation or muscle atrophy, which occur in approximately 14.7% of immobilization cases 1
- If there is any significant displacement (>3mm), dorsal tilt (>10°), or intra-articular involvement, surgical management may be indicated instead of conservative treatment 1, 4
- For displaced fractures, rigid immobilization (casting) is preferred over removable splints 1
Evidence Strength
- Recent systematic reviews and randomized controlled trials have consistently shown that removable splints are as effective as casts for pain control and functional outcomes 2, 5
- The FORCE trial (2022) demonstrated equivalence in pain at 3 days between children treated with soft bandages and those with rigid immobilization, with no differences in pain or function during 6 weeks of follow-up 5
Common Pitfalls to Avoid
- Overtreatment with rigid casting when a removable splint would suffice 2, 6
- Unnecessary follow-up appointments and radiographs that increase healthcare costs without improving outcomes 2, 3
- Failure to encourage active finger motion exercises, which can lead to stiffness 1
- Misdiagnosing adult torus fractures as simple wrist sprains, which may lead to inadequate treatment 7