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Best Practice Case Studies
Torus (Buckle) Fracture
Torus (Buckle) Fracture
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Video Transcription
This is Barry Belosis, one of the musculoskeletal radiology fellows at Stanford University. Nine-year-old female with complaints of left proximal forearm pain following a trampoline accident concerned for buccal fracture. The patient in this case presented with this radiograph demonstrating a buccal fracture right here involving the distal ulnar diaphysis. Although not commonly used in evaluating for fracture, ultrasound has been performed in this patient. Ultrasound can demonstrate a cortical step-off of the echogenic cortex as seen here consistent with a buccal fracture. This is on a different patient presenting with wrist pain. Buccal fractures are incomplete fractures of the shaft of a lung bone that is characterized by bulging of the cortex as we can see here. They result from trabecular compression due to an axial loading force along the long axis of the bone. Here on our frontal radiograph, we can see the buckling of the distal radial diaphysis and also of the distal ulnar diaphysis. These types of fractures are commonly seen in children aged 5 to 10 years of old due to the elasticity of their bones. In some cases, only the buckling of the cortex are seen without discrete fracture lines such as here in the distal ulnar buccal fracture.
Video Summary
A nine-year-old female sustained a buccal fracture of the distal ulnar diaphysis following a trampoline accident. Buccal fractures are incomplete fractures typically occurring in children aged 5 to 10 due to their bone elasticity, characterized by a cortex bulge from trabecular compression. While not commonly used, an ultrasound in this case verified the fracture by revealing cortical irregularities. Radiographs showed buckling in both the distal radial and ulnar diaphyses. Buccal fractures result from axial loading forces and may present without clear fracture lines, showing only cortex buckling.
Meta Tag
Edition
2nd Edition
Related Case
2nd Edition, CASE 08
Topic
Elbow and Forearm
Keywords
2nd Edition, CASE 08
2nd Edition
Elbow and Forearm
buccal fracture
trampoline accident
ultrasound verification
cortex buckling
axial loading forces
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