Fractures in children present differently to those in adults. Childrens' bones are more supple and frequently fracture without breaking all the way through. This gives rise to buckle, torus and greenstick fractures. Also, Salter-Harris fractures occur through the weaker growth plate.
Buckle and torus fractures are often used synonymously where the cortex fails and deforms, but the descriptive terms demonstrate a differing appearance. Torus is derived from the latin for ring (like a donut). Greenstick fractures are distinct and should not be confused with the former two. Greenstick fractures are where one cortex breaks whilst the other remains intact. This has been likened to a the break of a green stick, however, if you try to break a green stick you will find a buckle or torus fracture is easier to reproduce!
Note the normal appearances of a child's wrist below. There are no angles - every line is smooth.
Below are some examples of buckle and torus fractures.
Compare with a greenstic fracture of the tibia:
For more information on spotting fractures in children, please see the following articles:
- Non-accidental injury
- Radiocapitellar line
- Anterior humeral line
- Fat pads
- CRITOL ossification centres
- Salter-Harris fractures