Epidemiologic evaluation of torus fractures of radius in Turkey and comparison of different immobilization modalities

Abstract

Torus fracture of the distal radius is one of the most common pediatric fractures. Though inherently stable, the literature lacks data about the complications or refracture rates after these fractures. The aim of this study was to evaluate the epidemiology of torus fractures of the distal radius in Turkey and to compare rigid and non-rigid immobilization modalities. 598 patients were enrolled in this retrospective study. Medical data such as age, gender, mechanism of the injury, duration and type of treatment were collected as well as the complications during this period. “The Faces Pain Scale – Revised” (FPSR) was used for the assessment of pain before and after the treatment. The mean age was 7.1± 3.6 and the median follow-up was 12 (9-15) months. 181 patients were treated with plaster of paris, 149 with soft casts, 80 with hard casts and 188 with splints. The mean duration of the immobilization was 22.6±5.39 days. FPSR scores before and after the treatment were 2.837(95%CI, 2.686-2.989) and 0.255 (95%CI, 0.186-0.324), respectively (p=0.001). There was no statistically significant difference between the immobilization modalities in terms of FPSR decline before and after the treatment (p=0.403). The overall complication rate was 7.4% among all patients (95% CI, 5.3%-9.5%). Complication rates for each stabilization modality were 13.3% for the plaster of paris, 6.7% for the soft cast, 10% for hard cast and 1.1% for the splint group. The complication rate in the patients treated with splints was statistically significantly lower in the splint group (p=0.001; p=0.033; p=0.002, respectively). The pain was the most common complication (47.8% of all complications). There were 2 refractures during the follow-up period. In conclusion, torus fractures are stable and do not require rigid immobilization. The refracture rate is below 1% and any increase in this rate should be further questioned in order to rule out a misdiagnosis of “green-stick” fracture.