43t-M/2.1   Torus/buckle fracture of the distal tibial metaphysis

A torus/buckle injury of the distal tibial metaphysis is due to cortical failure in compression and is, therefore, minimally displaced and stable.

These fractures are classified as 43t-M/2.1.

An associated fracture of the fibula is usually a torus/buckle injury and is classified separately.

A buckle/torus fracture of the distal tibial metaphysis typically occurs in young children and heals rapidly.

This fracture is usually caused by low-energy trauma, eg, a simple fall.

Patients may still be able to walk, albeit with a limp.

Always consider nonaccidental injury in nonwalking children with a tibial fracture.

X-rays showing a buckle fracture of the tibia and fibula in an 18-month-old patient