Distal radial torus fracture in an adult. A new type of occult wrist fracture?
DOI:
https://doi.org/10.23938/ASSN.0386Keywords:
Torus fracture. Radius. Adult. Occult fracture.Abstract
Torus or buckle fractures typically affect children who have suffered indirect minor wrist injuries. They are axial compression-type metaphyseal fractures of cortical and cancellous bone, which are stable and their treatment therefore consists in immobilisation of the joint for three to four weeks.
We present an atypical case of distal radius torus fracture in a 19-year-old adult male, which has not been previously reported in adults and can be considered a new type of occult fracture. Knowledge of this possibility is mandatory to be able to make a differential diagnosis of wrist sprain in adults, and avoid performing superfluous complementary tests due to the persistence of pain and functional incapacity.
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LIGHT TR, OGDEN DA, OGDEN JA. The anatomy of metaphyseal torus fractures. Clin Orthop Relat Res 1984; 188: 103-111.
LOVE JC, SYMES SA. Understanding rib fracture patterns: Incomplete and buckle fractures. J Forensic Sci 2004; 49: 1153-1158.
CHO SH, SUNG YM, KIM MS. Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT. Br J Radiol 2012; 85: e845-e850.
SAURA-INGLES A, GARCIA-BALLESTA C, PÉREZ-LAJARIN L, LÓPEZ-JORNET P. Fracture in the chin area: an unusual case of mandibular torus fracture. Br Dent J 2005; 199: 27-29.
DÓCZI J, SPRINGER G, RENNER A, MARTSA B. Occult distal radius fractures. J Hand Surg Br 1995; 20: 614-617.
BERGH TH, LINDAU T, BERNARDSHAW SV, BEHZADI M, SOLDAL LA, STEEN K et al. A new definition of wrist sprain necessary after findings in a prospective MRI study. Injury 2012; 43: 1732-1742.
JORGSHOLM P, THOMSEN NOB, BESJAKOV J, ABRAHAMSSON SO, BJÖRKMAN A. The benefict of magnetic resonance imaging for patients with posttraumatic radial wrist tenderness. J Hand Surg Am 2013; 38: 29-33.
GLICKEL SZ, HINOJOSA L, EDEN CM, BALUTIS E, ALTON-BARRON O. Predictive power of distal radial metaphyseal tenderness for diagnosing occult fracture. J Hand Surg Am 2017, 42: 835e1-835e4.
PARFITT AM. The two faces of growth: benefits and risks to bone integrity. Osteoporos Int 1994; 4: 382-398.
UHTHOFF HK, RAHN BA. Healing patterns of metaphyseal fractures. Clin Orthop Relat Res 1981; 160: 295-303.
ASPENBERG P, SANDBERG O. Distal radial fracture heal by direct woven bone formation. Acta Orthop 2013; 84: 297-300.
YANG KM, LYNCH M, O'DONNELL C. “Buckle” rib fracture: an artifact following cardio-pulmonary resuscitation detected on postmortem CT. Leg Med (Tokyo) 2011; 13: 233-239.
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LIGHT TR, OGDEN DA, OGDEN JA. The anatomy of metaphyseal torus fractures. Clin Orthop Relat Res 1984; 188: 103-111.
https://doi.org/10.1097/00003086-198409000-00013
LOVE JC, SYMES SA. Understanding rib fracture patterns: Incomplete and buckle fractures. J Forensic Sci 2004; 49: 1153-1158.
Cho SH, SUNG YM, KIM MS. Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT. Br J Radiol 2012; 85: e845-e850.
https://doi.org/10.1259/bjr/28575455
SAURA-INGLES A, GARCIA-BALLESTA C, PÉREZ-LAJARIN L, LÓPEZ-JORNET P. Fracture in the chin area: an unusual case of mandibular torus fracture. Br Dent J 2005; 199: 27-29.
https://doi.org/10.1038/sj.bdj.4812536
DÓCZI J, SPRINGER G, RENNER A, MARTSA B. Occult distal radius fractures. J Hand Surg Br 1995; 20: 614-617.
https://doi.org/10.1016/S0266-7681(05)80121-4
BERGH TH, LINDAU T, BERNARDSHAW SV, BEHZADI M, SOLDAL LA, STEEN K et al. A new definition of wrist sprain necessary after findings in a prospective MRI study. Injury 2012; 43: 1732-1742.
https://doi.org/10.1016/j.injury.2012.06.028
JORGSHOLM P, THOMSEN NOB, BESJAKOV J, ABRAHAMSSON SO, BJÖRKMAN A. The benefict of magnetic resonance imaging for patients with posttraumatic radial wrist tenderness. J Hand Surg Am 2013; 38: 29-33.
https://doi.org/10.1016/j.jhsa.2012.09.034
GLICKEL SZ, HINOJOSA L, EDEN CM, BALUTIS E, ALTON-BARRON O. Predictive power of distal radial metaphyseal tenderness for diagnosing occult fracture. J Hand Surg Am 2017, 42: 835e1-835e4.
https://doi.org/10.1016/j.jhsa.2017.05.032
PARFITT AM. The two faces of growth: benefits and risks to bone integrity. Osteoporos Int 1994; 4: 382-398.
https://doi.org/10.1007/BF01622201
UHTHOFF HK, RAHN BA. Healing patterns of metaphyseal fractures. Clin Orthop Relat Res 1981; 160: 295-303.
ASPENBERG P, SANDBERG O. Distal radial fracture heal by direct woven bone formation. Acta Orthop 2013; 84: 297-300.
https://doi.org/10.3109/17453674.2013.792769
YANG KM, LYNCH M, O'DONNELL C. "Buckle" rib fracture: an artifact following cardio-pulmonary resuscitation detected on postmortem CT. Leg Med (Tokyo) 2011; 13: 233-239.
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