Department of Emergency Medicine, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, The Netherlands.
J Trauma Acute Care Surg. 2012 Apr;72(4):1093-7. doi: 10.1097/TA.0b013e318248bf8a.
In a torus fracture, there is an intact cortex at the side of the fracture which gives more intrinsic stability than in greenstick fractures, where one side of the cortex is disrupted. Two previously done studies compared soft bandage therapy (BT) with cast therapy in the treatment of torus forearm fractures in children and showed this is safe and does not cause any complications. The aim of our study was to validate these studies by treating all patients presenting to emergency department with a torus fracture with BT and investigate whether any complications occur.
At a single-center from January 2009 to June 2009, all patients with an impacted greenstick fracture of the distal radius and/or ulna without exception were treated using BT. Primary endpoint was secondary angulation; secondary endpoint was pain on Visual Analog Score.
Seven patients were misdiagnosed as torus fractures but were actually greenstick fractures and had to be excluded. A total of 49 patients with a torus fracture were included in statistical analysis. No fracture displacement was seen. Four patients needed an additional nonsteroidal antiinflammatory drug or an antalgic plaster cast. The overall Visual Analog Score of the patients was lower than in previous studies.
Soft BT is safe in all children without risk of further angulation and with a pain score equal to cast therapy. Important is that misdiagnosis of the torus fracture at initial presentation should be minimized.
在环状骨骨折中，骨折侧有完整的皮质，比皮质一侧中断的青枝骨折具有更高的内在稳定性。两项先前的研究比较了软绷带治疗（BT）与石膏治疗在儿童环状前臂骨折治疗中的效果，结果表明 BT 是安全的，不会引起任何并发症。我们的研究旨在通过对所有急诊就诊的环状骨骨折患者进行 BT 治疗来验证这些研究，并研究是否会发生任何并发症。
在 2009 年 1 月至 6 月的单中心研究中，所有桡骨和/或尺骨远端单纯青枝骨折的患者均采用 BT 治疗。主要终点是继发成角；次要终点是视觉模拟评分（VAS）疼痛。
7 例患者误诊为环状骨骨折，但实际上是青枝骨折，必须排除在外。共有 49 例环状骨骨折患者纳入统计分析。未观察到骨折移位。4 例患者需要额外使用非甾体抗炎药或止痛石膏绷带。患者的总体 VAS 评分低于以往的研究。
BT 对所有儿童均安全，不会增加成角风险，疼痛评分与石膏治疗相当。重要的是，应尽量减少初始诊断时环状骨骨折的误诊。
