"Splinting versus casting of "torus" fractures to the distal radius in the paediatric patient presenting at the emergency department (ED): a literature review". "Minimalistic approach to treating wrist torus fractures". ^ van Bosse, HJ Patel, RJ Thacker, M Sala, DA (July 2005)."Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures". ^ Randsborg, PH Sivertsen, EA (October 2009)."Core curriculum illustration: pediatric buckle fracture of the distal radius". ^ Sharp, JW Edwards, RM (August 2019).Emergency Medicine Clinics of North America. "Emergency department evaluation and treatment of pediatric orthopedic injuries". ^ Della-Giustina, K Della-Giustina, DA (November 1999)."Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States". ^ Naranje, SM Erali, RA Warner WC, Jr Sawyer, JR Kelly, DM (June 2016).Other studies have also shown that, with removable splints that can be taken off at home, without the need for outpatient clinics, parental satisfaction of nearly 100% is achieved. This offered clinicians, parents and young people reassurance that this fracture will heal well, without complications and immobilisation and follow-up is almost always not needed.įurthermore, a national guideline from the UK National Institute for Health and Care Excellence (NICE), which was published before the FORCE study, identified that all treatments appeared safe and recommended either a removable splint or a bandage, without the need for a follow-up. 965 children were in this study, which showed equivalent results for pain scores, function and complications between the treatments. This study fairly allocated children (through randomisation) to either splint and routine follow-up, or a bandage and no follow-up. The study was conducted throughout the UK in 21 emergency departments. However, in 2022 the largest and highest quality treatment study was published about this injury in the Lancet medical journal - called the FORCE Study (see infographic in images). There is no established 'standard' treatment for buckle fractures. The bone may have a slight angulation.The buckling of cortical bone, which may appear as a small bulge or protuberance in the radius or ulna.The diagnosis of a torus fracture is made from both anterior/posterior and lateral projections. Diagnosis īuckle fracturs can be identified by performing a radiograph. Such orthopaedic injuries are distinctive in children as their bones are softer and in a dynamic state of bone growth and development, with a higher collagen to bone ratio so incomplete fractures such as the buckle fracture are a more common occurrence. As aforementioned, the most common buckle fracture is of the distal radius in the forearm, which typically originates from a Fall Onto an Outstretched Hand ( FOOSH). Physical activities or sports such as bike riding or climbing increase the associated risk for buckle fractures in the potential event of a collision or fall. As with other fractures, the site of fracture may be tender to touch and cause a sharp pain if pressure is exerted on the injured area. This mechanism is analogous to the crumple zones in cars. As the bone buckles (or crushes), instead of breaking, they are a stable injury as there is no displacement of the bone. Torus fractures are low risk and may cause acute pain. Bone densitometry.Simplified diagram of a buckle fracture Signs and symptoms The pediatric polytrauma patient: current concepts. Buckle fractures of the distal radius in children.
Fractures in children.īen-yakov M, Boutis K.
#BUCKLE FRACTURE ULNA SERIES#
Short arm cast: Casting immobilization series for primary care. Garcia-rodriguez JA, Longino PD, Johnston I. Outcomes of long-arm casting versus double-sugar-tong splinting of acute pediatric distal forearm fractures. Levy J, Ernat J, Song D, Cook JB, Judd D, Shaha S. Buckling down on torus fractures: has evolving evidence affected practice?. Williams BA, Alvarado CA, Montoya-williams DC, Matthias RC, Blakemore LC. Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States. Naranje SM, Erali RA, Warner WC Jr, Sawyer JR, Kelly DM. Greenstick Fractures.Īmerican Academy of Pediatrics.
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