Monday, July 30, 2018

Greenstick and Torus fractures

Torus Fractures (Buckle/Cortical Fractures)


Torus fracture is an injury of the cortex on the non-compressive side of the bone with an intact cortex on the tension side. Torus is derived from Latin (tori) meaning a swelling or protuberance. Deformity should not occur in torus fracture because the periosteum and cortex are intact on the side of the bone opposite to fracture. The distal end of the radius is the most common site for a torus fracture. Compressive forces often result in a bulging or buckling of the periosteum rather than a more complete fracture line. these injuries usually involve the metaphysis. A simple torus fracture will not produce a visible deformity to the shape of the extremity; however, there is typically soft tissue swelling and point tenderness over the bony injury. 


Radiographically, the torus fracture may be subtle. Carefully inspect the contour of the metaphyseal flare. Any asymmetry, bulging, or deviation of the cortical margin indicates a torus fracture. Soft tissue swelling is also usually evident. Torus fractures are not associated with angulation, displacement, or rotational abnormalities, so reduction is not necessary. Treat by splinting in a position of function fracture clinic follow-up within 1 week. 


https://radiopaedia.org/cases/torus-fracture-1



Greenstick Fractures
greenstick fracture is characterized by cortical disruption and periosteal tearing on the convex side of the bone, with an intact periosteum on the concave side of the fracture. Greenstick fractures are more stable and somewhat less painful than complete fractures because the area of intact periosteum limits bony displacement. The need for reduction is determined by the degree of angulation of the fracture, the age of the child, and the anatomic location of the injury.


https://radiopaedia.org/cases/radius-and-ulna-greenstick-fractures

Posted by:

              
     Lakshay Chanana
     
     Speciality Doctor
     Northwick Park Hospital
     Department of Emergency Medicine
     England

     @EMDidactic



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