Torus Forearm Fracture (Child)  

There are two bones within the forearm: the radius and the ulna. Children’s bones are more elastic than those of adults. Therefore, in children it is not uncommon to see a partial fracture of bones. A torus, or buckle, fracture occurs when the outer layers of the bone twist or bend under impact or pressure. The most common site for this type of fracture is in the radius bone (the bone on the same side as the thumb) of the forearm. These fractures most often occur in children.

These types of injuries may be seen on X-rays. More than one set of X-rays may be needed to confirm the fracture. 

To hold the bone in place while it heals, the arm is put into a splint or a cast. Torus fractures often heal faster than other types of fractures.

Home care

• Give your child pain medicines as directed by the healthcare provider. Don't give your child aspirin unless told to by a healthcare provider.
• Follow the healthcare provider's instructions about how much your child should use the affected arm.
• Keep the child's arm elevated to reduce pain and swelling. This is most important during the first 48 hours after injury. As often as possible, have the child sit or lie down and place pillows under the child’s arm until it is raised above the level of the heart. For infants or toddlers, lay the child down and place pillows under the arm until the injury is raised above the level of the heart. Be sure that the pillows do not move near the face of the infant or toddler. Never leave your child unsupervised.
• Apply a cold pack to the injury to help control swelling. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Do not place the ice directly on the skin, as this can cause damage. You can place a cold pack directly over a splint or cast.
• Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 days, then as needed. It may help to make a game of using the ice. But if your child objects, don't force your child to use the ice. 
• Care for the splint or cast as you’ve been instructed. Don’t put any powders or lotions inside the splint or cast. Keep your child from sticking objects into the splint or cast.
• Keep the splint or cast completely dry at all times. The splint or cast should be covered with a plastic bag and kept out of the water when your child bathes. Close the top end of the bag with tape or rubber bands.
• Encourage your child to wiggle or exercise his or her fingers of the affected arm often. 

Follow-up care

Follow up with the child's healthcare provider or as advised. Follow-up X-rays may be needed to see how the bone is healing. If your child was given a splint, it may be changed to a cast at the follow-up visit. The doctor may refer your child to follow up with a physical therapist for exercises to help him or her get back strength and mobility in the arm.  If you were referred to a physical therapist or another specialist, make that appointment as soon as possible.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for protection of the child. Please try to be patient and not take offense.

When to seek medical advice

Call your child's healthcare provider if any of these occur:

• Wet or soft splint or cast
• Splint or cast is too tight (loosen a splint before going for help)
• Increasing swelling or pain after a cast or splint is put on (nonverbal infants may indicate pain with crying that can't be soothed)
• Fingers on the injured hand are cold, blue, numb, burning, or tingly 
• Child can’t move the fingers of the hand on the affected arm
• Redness, warmth, swelling, or drainage from the wound, or foul odor from the cast or splint
• In infants: Fussiness or crying that cannot be soothed
• Fever (see Fever and children, below)

Call 911

Call 911 if your child has:

• Trouble breathing
• Confusion
• Trouble awakening or is very drowsy
• Fainting or loss of consciousness
• Rapid heart rate
• Seizure
• Stiff neck