But some fractures that look simple to treat can cause serious problems for children or teens and affect the bone’s ability to grow. This process is called remodeling.īecause of remodeling, a young person’s broken bone will heal better and with less treatment than a similar break in an adult. About half of all boys and a quarter of all girls break a bone sometime before adulthood.Ĭhildren are flexible, so their bones may bend after a break. This is not a common cause of fractures.įractures are very common in children and teens. This is usually due to holes in the bone (bone cysts) or certain bone conditions, such as brittle bone disorder (osteogenesis imperfecta), in which bones break easily. Pathologic fractures occur because the bone is weaker than normal.Stress fractures can happen when a child or teen repeats the same position or motion over and over for long periods of time.The bone gets more force than it is able to handle, and it breaks. Traumatic fractures occur due to injury, such as falling while running, biking or riding a skateboard.Open fractures are breaks in which the bone sticks through the skin.Simple fractures are breaks or cracks in the bone that do not break through the skin.Damage to growth plates or soft tissues may affect the way doctors treat your child’s fracture. Older children tend to get breaks during sports or other active play.Īn injury that breaks a bone may also damage a child’s growth plates or soft tissues that are near the bone or connect to the bone, such as skin, ligaments or tendons.In toddlers, breaks often happen when the tip of their finger gets caught in a door.The child hits (or is hit by) something hard.Their hand gets twisted, bent or smashed.Children and teens may break their finger or thumb bones (phalanges, fah-LAN-jeez), their wrist bones (carpals) or the long bones between their fingers and their wrist (metacarpals). Parents should be provided with an information leaflet containing the above information.Fractures are cracks or breaks in bones. Once the splint is removed the children should avoid contact sports or high energy activities (such as rough and tumble play) for a further 3 weeks to avoid further injury If after 3 weeks the wrist still seems very sore, swollen, or the child is not willing to use it, please contact the ED secretary on 01 where follow up arrangements will be made. If the child remains in significant distress despite the splint and regular analgesia, they should return to ED for review. They will usually be fine to attend school after the first day. The child should receive regular simple analgesia for the first few days following injury. The splint should be worn for 3 weeks, but can be removed for bathing, showering and for sleep. These patients can be discharged with a parent information leaflet and no planned follow up. Splint can be used if there is a buckle seen on both radius and ulna. This has been shown to be at least as effective as a cast in terms of facilitating healing, but can promote earlier functional recovery. A rigid cast is not recommended 4, instead a removable splint should be applied. (demonstrating extension of fracture line to volar cortex with angulation of the volar cortex)īuckle fractures have excellent cosmetic and functional prognosis. Imaging Findings of the Distal Radio-Ulnar Joint in Trauma - Scientific Figure on ResearchGate.Įxample xray of greenstick fracture of distal radius: Buckle fractures of the volar cortex should be in the same way as greenstick fractures, with below elbow backslab and fracture clinic 1 week.Įxample xray of Salter Harris type 2 fracture of distal radius:.Ensure there is no angulation especially of the volar cortex.Ensure the fracture line does not extend to the volar cortex.From the case rID: 10733īe careful not to misdiagnose Salter Harris II or Greenstick fractures as a simple Buckle fracture, as these can be unstable 3 requiring immobilisation with cast, and orthopaedic follow up. The bulge may be seen at both the ulnar and radial aspects of the bone.Įxample xray of distal radius buckle fracture:Ĭase courtesy of Dr Maulik S Patel,. This is most frequently seen on the dorsal aspect of the distal radius but can appear on distal ulna or both distal ulna and radius. 1īuckle fractures are common injuries sustained by children >2 years old 2, typically following a fall on the outstretched hand.Īs the developing bone is relatively soft, the trabeculae is compressed, resulting in the appearance of a bulge. Incomplete compression fracture at the metaphysis of the distal radius, ulna or both in which one cortex is disrupted, and the other remains intact.
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