What level of immobilisation is necessary for treatment of torus (buckle) fractures of the distal radius in children?

### What you need to know Torus (buckle) fractures are the most common fractures of the wrist in children, involving the distal radius and/or ulna bone (fig 1).1 They typically occur in children up to age 14, usually after a low energy fall.2 The flexibility of immature bone in children enables force to be absorbed as with the “crumple zone” of a car: crushing—or buckling—as it is injured. Such fractures differ from greenstick fractures, in which the bone bends (rather than crushes), resulting in a complete break in one cortex and a bend on the opposite side (akin to snapping a fresh twig from a tree). Torus fractures result in a mild deformity without a break in the bone surface, and pain is the main clinical feature. The child may need assistance with schoolwork, time off physical activities, and help with self-care during the recovery period. Fig 1 Anteroposterior (a) and lateral (b) radiographs of the wrist showing a torus fracture of the distal radius and ulna with compression of the bones dorsally, though no break in the bone surface Parents typically expect that any fracture needs plaster cast immobilisation to ensure adequate healing. However, torus fractures heal quickly, with pain almost completely resolved three weeks after …