Distal radius torus fractures overlooked in emergency department: What happens?
Mehmet Cenk Turgut, Serdar Toy, Sultan Tuna Akgol Gur, Abdullah Osman Kocak, Ahmet Kose
A third of all fractures in childhood occur at the wrist level due to falling on an open hand. Torus fractures without separation in the cortex in which integrity is not disturbed result from thick periost and bone elasticity in children. Several studies have shown that in torus fractures, plaster immobilization and long-term follow-up are not necessary. This study aims to draw attention to unnecessary long-term immobilization, labor loss, and radiation exposure in distal radius torus fractures. It was found that patients admitted to the emergency room, between January 2019 and April 2020, with upper extremity trauma had torus fractures overlooked by retrospective x-ray examinations. Age, gender, the affected side, pain, function, and complications of patients with distal radius torus fractures were recorded by phone or face-to-face interviews. Of the 111 patients in the study, 20 (18.0%) stated that they re-admitted to the hospital due to pain and 6 (5.4%) due to joint mobility limitations. It was observed that all of the patients who were re-admitted to the hospital were evaluated by repetition of x-ray examinations, and a long arm splint was applied to all of them. It was understood that none of the remaining 85 patients were admitted to the hospital again for this reason, and none of them completed this healing process without using plaster-splint without limiting their functionality. None of the patients had pain and loss of function big enough to affect their daily activities. None of the 111 patients who were able to come for re-examination had joint movement loss, elastic deformation, and cosmetic defects. No patient was asked to have an x-ray again because it would be unnecessary. Long-term immobilization, circular plaster application, and serial x-ray controls constitute unnecessary loss of labor and patient exposure in distal radius torus fractures. Treatment of distal radius torus fractures that do not have a heavy load exposure, such as lower extremity, should be done with elastic bandages with short-term follow-up and by addressing the concerns of the patient’s family.
Key words:Bandage, cast, splint, torus