![]() Further research is essential to determine the stability of the angled DRBF subtype and whether they should continue to be defined and managed as buckle fractures.ĭistal radius buckle (torus) fractures (DRBFs) (Figure (Figure1) 1) are the most frequent type of pediatric fracture and account for the highest number of fracture visits to emergency departments in the United States. Radiographic evidence supporting or denying this claim is limited. Angled DRBFs have been theorized to have intraphyseal extension, making them unstable Salter-Harris fractures. Despite the discrepancies in categorizing DRBFs, complication rates remain low, and diagnostic confusion insignificantly affects clinical outcomes. Yet, new protocols implementing removable elastic bandages have had comparable results to casting, including reduced healthcare expenditure, less stiffness, and improved convenience and patient tolerability. Rigid immobilization with short-arm casting continues to be the mainstay of treatment in clinical practice. Without universal diagnostic criteria, misdiagnosis is common, and the utilization of flexible treatment modalities is infrequent. Some authors refute the existence of angled DRBFs, instead proposing new criteria for DRBF classification: measuring more than 1 cm away from the physis with two to three inflection points. In this review, we discuss angled DRBFs, a hypothesized subset of buckle fractures that results from an off-center compressive force. DRBFs lack cortical and physeal disruption, which makes them relatively stable. They result from compressive forces applied to a child’s highly plastic radius. Distal radius buckle fractures (DRBFs) are the most common pediatric fractures and resemble the rounded portion of a Greek pillar or torus.
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