![]() ![]() 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. There is no evidence of issues with growth, function, ability or stability after these injuries.The pediatric skeletal anatomy has unique properties that lead to varied pathology to that of the adult skeleton.It is important to have full strength and full range of motion, without pain, before returning to activities.Tenderness, weakness and stiffness may last for one to two weeks following the splint removal.No follow-up appointment is needed in most cases.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. In our Fracture Clinic at the Frisco campus, our team cares for various types of fractures – from simple to complex. ![]()
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