A break in the periosteum; most common in pediatric patients is which type of fracture?

• A. Buckle Fracture
• B. Greenstick Fracture
• C. Comminuted Fracture
• D. Spiral Fracture

Answer: (A)

In kids, bones are softer and more pliable, so a force that might cause a full break in an adult often produces a bend or buckle instead. A buckling fracture, or torus fracture, results when the bone cortex is compressed enough to bulge inward but without a complete fracture line forming. This pattern is the most common incomplete fracture in pediatric patients because the pliable bone accommodates the load by bending rather than cracking entirely. The periosteum in children is thick and supportive, and while minor periosteal stretching can occur, there isn’t a full periosteal break as you’d see with a complete fracture pattern. That tendency toward cortical buckling under compression explains why buckling fractures are the best answer for a pediatric fracture described in this way.