![]() Parents should be provided with an information leaflet containing the above information. Once the splint is removed the children should avoid contact sports or high energy activities (such as rough and tumble play) for a further 3 weeks to avoid further injury If after 3 weeks the wrist still seems very sore, swollen, or the child is not willing to use it, please contact the ED secretary on 01 where follow up arrangements will be made. If the child remains in significant distress despite the splint and regular analgesia, they should return to ED for review. They will usually be fine to attend school after the first day. ![]() The child should receive regular simple analgesia for the first few days following injury. Overview A buckle fracture is sometimes referred to as an incomplete fracture, because the break is only on one side of the long bone of the arm or leg. The splint should be worn for 3 weeks, but can be removed for bathing, showering and for sleep. These patients can be discharged with a parent information leaflet and no planned follow up. Splint can be used if there is a buckle seen on both radius and ulna. This has been shown to be at least as effective as a cast in terms of facilitating healing, but can promote earlier functional recovery. A rigid cast is not recommended 4, instead a removable splint should be applied. (demonstrating extension of fracture line to volar cortex with angulation of the volar cortex)īuckle fractures have excellent cosmetic and functional prognosis. Imaging Findings of the Distal Radio-Ulnar Joint in Trauma - Scientific Figure on ResearchGate.Įxample xray of greenstick fracture of distal radius: On the other hand, a full break or a complete. Buckle fractures of the volar cortex should be in the same way as greenstick fractures, with below elbow backslab and fracture clinic 1 week.Įxample xray of Salter Harris type 2 fracture of distal radius: In a buckle fracture, the injury is usually stable and will heal on its own with the help of a cast or splint.Ensure there is no angulation especially of the volar cortex.Ensure the fracture line does not extend to the volar cortex.From the case rID: 10733īe careful not to misdiagnose Salter Harris II or Greenstick fractures as a simple Buckle fracture, as these can be unstable 3 requiring immobilisation with cast, and orthopaedic follow up. The bulge may be seen at both the ulnar and radial aspects of the bone.Įxample xray of distal radius buckle fracture:Ĭase courtesy of Dr Maulik S Patel,. This is most frequently seen on the dorsal aspect of the distal radius but can appear on distal ulna or both distal ulna and radius. 1īuckle fractures are common injuries sustained by children >2 years old 2, typically following a fall on the outstretched hand.Īs the developing bone is relatively soft, the trabeculae is compressed, resulting in the appearance of a bulge. 2005 25(3):322-325.Incomplete compression fracture at the metaphysis of the distal radius, ulna or both in which one cortex is disrupted, and the other remains intact. Buckle fractures of the distal radius are safely treated in a soft bandage: a randomized prospective trial of bandage versus plaster cast. West S, Andrews J, Bebbington A, et al.One brace: one visit: treatment of pediatric distal radius buckle fractures with a removable wrist brace and no follow-up visit. Increasing brace treatment for pediatric distal radius buckle fractures: using quality improvement methodology to implement evidence-based medicine. Little KJ, Godfrey J, Cornwall R, et al.American Medical Society for Sports Medicine.Parent satisfaction is also increased when these fractures are treated with a brace. Treating in a cast and repeating x-rays increases health care costs and radiation exposure for the patient. Radius buckle fractures can be safely treated with a Velcro removable wrist splint for three to four weeks, as long as the following conditions are met: 1) cortex is intact, 2) there are no fracture lines extending to the physis on any view, 3) there is no angulation or displacement of the fracture, 4) there are two or three inflection points seen in the cortex on either view that best represents the fracture, and 5) the parent can do a symptom check with instructions. These fractures are inherently stable and have an excellent prognosis. Distal radius buckle fractures are one of the most common wrist fractures in children.
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