A 4 yo M presents to the ED with R wrist pain after a fall from the monkey bars. His exam reveals mild swelling and pain over the R distal radius without obvious deformity or neurovascular compromise. An xray is obtained. What's the diagnosis? (scroll down for answer)

Answer: Buckle or Torus Fractue of the Distal Radius

• Compressive force that results in bulging/buckling of the periosteum instead of a complete fracture line
• Does not produce visible deformity
• Exam significant for soft tissue swelling, point tenderness
• Can be subtle on xray- look for any asymmetry, bulging or deviation of the cortical margin
• Treatment: splint in position of function, follow up with orthopedics