Torus Forearm Fracture (Child)
The forearm has two bones: the radius and the ulna. Children’s bones are more elastic than those of adults. So, in children it's not uncommon to see a partial fracture of bones. A torus (buckle) fracture occurs when the outer layers of the bone twist. compress, or bend under impact or pressure. The most common site for this type of fracture is in the radius bone. These fractures most often occur in children. This is a stable fracture. This means the broken pieces of bone are still in place.
These types of injuries may be seen on X-rays. More than 1 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
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Give your child pain medicines as directed by the health care provider. Don't give your child aspirin unless told to by a provider.
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Follow the provider's directions about how much your child should use the affected arm.
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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's raised above the level of the heart. For babies and 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 baby or toddler. Never leave your child unsupervised.
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Apply a cold pack to the injury to help control swelling. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel or cloth before using it. As the ice melts, be careful that the cast or splint doesn’t get wet. Don't place the ice directly on the skin, because this can cause damage. You can place a cold pack directly over a splint or cast.
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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.
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Care for the splint or cast as you’ve been told. Don’t put any powders or lotions inside the splint or cast. Keep your child from sticking objects into the splint or cast.
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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.
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Encourage your child to wiggle or exercise their fingers of the affected arm often.
Follow-up care
Follow up with the child's health care provider 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. If you were referred to a specialist, make that appointment promptly.
Special note to parents
Health care providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several health care providers may ask questions about how your child was injured. Providers must, by law, ask you these questions. This is done for protection of the child. Please try to be patient and not take offense.
When to get medical advice
Contact your child's health care provider if your child has:
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A wet or soft splint or cast.
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A splint or cast that is too tight. Loosen a splint before going for help.
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Increasing swelling or pain after a cast or splint is put on. Babies who can't yet talk may show pain by crying and can't be soothed.
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Fingers on the injured hand that are cold, blue, numb, burning, or tingly.
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Fingers of the hand on the affected arm that they can't move.
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Redness, warmth, swelling, or drainage from the wound, or a foul odor from the cast or splint.
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Fussiness or crying that can't be soothed.
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A fever (see "Fever and children" below).
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Chills.
Call 911
Call 911 right away if your child has:
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.
Below is when to call the provider if your child has a fever. Your child’s provider may give you different numbers. Follow their instructions.
When to call a health care provider about your child’s fever
For a baby under 3 months old:
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First, ask your child’s provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the provider
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the provider
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the provider