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.
#Buckle fracture wrist treatment full
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. Ideally, the treatment mentioned above is offered in the emergency department, and the patient is discharged, but in many cases, they are often referred onwards to fracture clinics for follow-up.In our Fracture Clinic at the Frisco campus, our team cares for various types of fractures – from simple to complex. Thus, these patients can be safely discharged with appropriate parental counseling on the removal of the splint/soft cast and to avoid any contact sports or dangerous activities for six to eight weeks from injury. This splinting/casting is usually only necessary for two to three weeks because these fractures are considered stable.Įvidence from RCTs have shown removable splints to be the best treatment, which offers easier use for daily activities, better physical function, and are generally preferred by patient and parent in comparison to below elbow casting. įollowing an adequate history and physical examination, if the relevant X-rays show an isolated injury, then the treatment is with removable wrist splints, a pre-fabricated removable cast, or a soft cast that can be removed once at home by the parents once the treatment has finished. These are inherently stable injuries and almost never require any further intervention. Treatment goals in buckle fractures are for patient comfort and parental reassurance. Therefore, an ever-present high index of suspicion is required, particularly if any inconsistencies in the history, delayed presentation, multiple injuries of different ages, or if the mechanism of injury does not equate to the given fracture pattern. One must also be aware that although radiographs may show a buckle fracture if a clinical deformity exists, there may also be a plastic deformation that requires correction.įinally, with children, one must always be wary of non-accidental injury (NAI). Additionally, general principles for the assessment of any bruising, swelling, or bony tenderness around the site of injury may indicate a fracture. Like with every trauma case, one should ascertain if there are any other injuries and to make sure this is not a distracting injury to something more pressing.ĭuring the physical examination, inspection is key, and one must assess for any clinical deformities.
As with any trauma history, the mechanism of injury is of utmost importance. The history and physical examination of these injuries are relatively simple.
However, if there is a fracture with a cortical breach, it is termed a greenstick fracture if unicortical or a complete fracture if bicortical.īuckle fractures are incredibly common injuries that present to the emergency department, which are invariably always managed conservatively, and do not routinely require orthopedic input. The appearance on plain X-ray shows the fracture site as two outcroppings of bone, as though the long bone has collapsed or ‘buckled.’ The word "torus" is the Latin word "protuberance.
In long bones, injuries without a cortical break either lead to plastic deformation through microfracture or to a ‘kink’ within the long bone, described as a ‘buckle’ or ‘torus’ fracture. With soft, malleable bone, and a thick protective periosteal covering, minor injuries can result in a spectrum of deformities with or without a cortical break. Two of the major differences include the presence of the physeal growth plate and a thicker periosteum with the softer underlying bone. The pediatric skeletal anatomy has unique properties that lead to varied pathology to that of the adult skeleton.
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