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What is a Buckle Fracture?

Updated: Jun 14

X-ray image showing buckling of the cortex of the distal radius

Buckle fractures at the wrist (radius and/or ulna) are a common childhood injury. Because children's bones are less brittle than adults' bones, the surface of the bone may 'buckle' instead of the bone breaking right through. Sometimes called Torus fractures, buckle fractures result from compression of a bone, typically from falling on an outstretched hand.

It may be difficult to recognize when your child has sustained a buckle fracture as there may be no noticeable deformity, but the wrist may be swollen or bruised and painful to touch. A small bump can sometimes be seen or felt. The child will usually avoid moving or using the arm due to pain.

Custom made wrist immobilisation splint to protect a buckle fracture in a child

Fortunately, an operation is never required for these fractures as the bone has not moved out of position. The best method of treatment is immobilisation in a splint. Whilst off the shelf splints are available, these

are often poorly fitting, very hot to wear and unable to be cleaned. A better option is to have a custom-made thermoplastic splint fitted by a hand therapist. Thermoplastic splints are fully washable and may be removed for bathing but they should be worn at all other times including sleeping. The splint is usually required for 4 weeks.

These fractures very rarely have any complications so a follow-up x-ray is not required. Usually after 4 weeks of immobilisation, if the fracture is not tender when pressure is applied, the splint can be removed. Your child should avoid contact sports and rough play for 6-8 weeks following the injury.

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