DisclaimerThese guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline. Show
Read the full PCH Emergency Department disclaimer. Mechanism of injuryThe most common mechanism of injury is a fall onto an outstretched hand. Examination
Imaging
General managementFor general assessment and management, see Fractures - Overview. Specific managementBuckle fractures6
Simple dorsal buckle fracture of the distal radius and ulna with minimal dorsal angulationSimple dorsal buckle fractures must have ALL of the following features:
Management
Buckle fractures that should not be managed in a wrist splintBuckle fracture with volar angulation (left)Disruption of cortex of volar aspect of radius- arrow (right)Metaphyseal Fractures
Undisplaced distal radius fractures
Undisplaced distal radius and ulna fractures
Fractures with > 20° dorsal or > 10° volar angulation or clinical deformity
Transverse fracture of distal radius with 15 degree dorsal angulation (left)Completely displaced fracture of distal radius and ulna (right)Galeazzi fracture dislocation
Galeazzi fracture dislocationRadial physeal fractures
Salter Harris I and II fractures
Salter Harris III and IV fractures
Scaphoid fractures
Displaced scaphoid fractures
Undisplaced scaphoid fractures
Suspected scaphoid fracture with normal X-ray
A: Undisplaced distal scaphoid fracture. B: Sclerotic line in follow up X-Ray 2 weeks later.Monteggia Fracture Dislocation
Monteggia FractureBibliography
How long does a radial buckle fracture take to heal?They're very common in children under 12, and can almost always be treated with a splint. Your child will not need surgery. Buckle fractures take around a month to heal.
What is a distal radial metaphyseal fracture?When the radius breaks near the wrist, it is called a distal radius fracture. The break usually happens due to falling on an outstretched or flexed hand. It can also happen in a car accident, a bike accident, a skiing accident or another sports activity.
What is a cortical buckle fracture?Buckle (torus) fractures occur when the bony cortex is compressed and bulges, without extension of the fracture into the cortex (Figure 1). This type of fracture occurs in about 1 in 25 children and represents 50% of pediatric fractures of the wrist.
How do you treat a buckle fracture of the distal radius?A buckle fracture is best treated with a splint rather than a full circular plaster cast. Because the bones are only partially broken, they heal very well within a few weeks with the support and protection that a splint provides.
|