The angled buckle fracture in pediatrics: a frequently missed fracture

Buckle (torus) fractures in childhood are very common, and most assume a typical configuration wherein the trabeculae across the fracture line are compressed and the corresponding cortex bulges outward (unilateral or bilateral). In other cases the fracture merely shows cortical angulation along one side of the bone and classical buckling is not present. These latter fractures frequently are subtle and easily overlooked. However, if one knows what they look like and where they are likely to occur, one is able to detect them with greater frequency and confidence. The purpose of this communication is to bring attention to this fracture, describe the mechanism by which it occurs, and indicate its most common sites.