Buckle fractures typically heal within four weeks from the injury.The splint should only be taken off with parent’s help during showering/bathing and for a daily skin check. It is important to wear the splint for the full time, even after the pain is gone. The splint helps protect the bone and keep it still to allow for adequate healing. In many cases, X-rays will be used to see if the arm is fractured/broken.Ī removable wrist splint is worn for four weeks. Limited range of motion in the wrist or forearm following the injury.Ī detailed history and physical exam will be performed. Often this injury occurs from a fall on outstretched hand, or “FOOSH.” Generally, buckle fractures occur in the distal radius portion of the wrist and occurs when falling on the hand. It can also be called an incomplete fracture. Pediatric bones are softer and more flexible than adult bones, therefore this is a very common injury for children. One side of the bone may buckle or bend upon itself without breaking the other side of the bone. In general, the patient seen in our clinic do well with this type of fracture and are able to return to full activity quickly after splint removal.Ī buckle fracture or torus fracture is a break in the bone. These fractures heal well with splint immobilization for four weeks. The distal radius buckle fracture is one of the most commonly seen fractures in our patient population. It is important to be seen by a pediatric specialist when your child gets injured because treating growing bones is different than treating adult bones. These injuries require rigid immobilization and orthopedic consultation.In our Fracture Clinic at the Frisco campus, our team cares for various types of fractures – from simple to complex. Radiographs should be scrutinized for other diagnoses since minimally displaced greenstick and Salter–Harris II fractures of the distal radius may be mistaken for buckle fractures 6. The key caveat is to ensure that the radiological diagnosis of distal radius buckle fracture is correct. 3,5,6 An orthopedic surgeon should be consulted if the child’s condition is not improving over time or the child has not fully recovered by six weeks. Follow-up with an orthopedic surgeon is not routinely necessary and these children can be safely followed up with a primary care physician. 2 Activities that could lead to re-injury should be avoided until the child has been free of symptoms for two weeks (about 6-8 weeks from time of injury). Most children use the splint regularly for two to three weeks and about 99% are fully recovered by four weeks. The duration of splint use and return to play should be guided primarily by pain and the degree of buckle fracture noted on the x-rays. Treatment with immobilization with a removable splint is used as needed to reduce pain and to protect against re-injury. 4 Further, these RCT’s demonstrated that parents and families preferred the removable splint, and splinting was found to be more cost-effective for the health care system. 2,3 Data from eight randomized control trials conducted in the UK, Canada and the US has demonstrated that treatment with a removable splint is at least as effective as a short arm cast with respect to recovery of physical function. The cosmetic and functional prognosis of this fracture is excellent even if it associated with an ulnar buckle/styloid fracture. 1įigure 1: Buckle Fracture of the Distal Radius Distal Radius Buckle Fracturesīuckle fractures of the distal radius represent about 50% of pediatric fractures of the wrist. This article reviews the evidence that recommends that management of the distal radius buckle fracture. Since these fractures are stable and have an excellent prognosis, they do not need to be routinely immobilized in a cast nor followed by an orthopedic surgeon. The dogmas of the past are now being challenged for the most common minor pediatric fractures, distal radius buckle fractures and minor distal fibular fractures.
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