• Buckle Fracture of Forearm

    (Torus Fracture)

    Definition

    A buckle fracture is a unique type of fracture that most often occurs in children. It is a compression fracture on one side of a bone that causes the bone to bend or buckle toward the damaged side. Buckle fractures are more common in children because their bones are softer and more able to bend.
    Buckle fractures of the forearm usually occur in the radius. The radius is the bone that runs along the thumb side of the arm forming most of the wrist joint.
    Normal Forearm Anatomy
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    Causes

    Most buckle fractures are the result of falling on an outstretched arm.
    Some buckle fractures may also occur with a direct blow to the forearm or wrist.

    Risk Factors

    Certain health conditions, such as tumors or vitamin D deficiency, can weaken bones.
    Other factors that may increase your child’s chance of a buckle fracture include:
    • Playing contact sports
    • Participating in activities that can result in falls, such as biking or skateboarding
    • Being in an accident

    Symptoms

    Buckle fractures may cause forearm or wrist pain, with or without swelling. Other symptoms may include:
    • Bowed out appearance
    • Tingling
    • Numbness
    • Limited movement
    • Bruising

    Diagnosis

    The doctor will ask about your child’s symptoms, medical history, and activities at the time of injury. The doctor will examine the wrist and forearm. If your child fell, the doctor may suspect a fracture.
    Imaging tests to assess the fracture may include:

    Treatment

    Initial Care

    A cast or splint will be used to help make sure the bone stays in the correct position while healing. Without immobilization, the bone will heal, but it may heal incorrectly, which can cause later problems with movement.
    Buckle fractures rarely result in complications or surgery.

    Medication

    Swelling and pain can be managed with over the counter or prescription pain medications.

    Rest and Recovery

    It may take up to 4 weeks for a buckle fracture to fully heal.
    Some physical activities will need to be adjusted so the bone can properly heal. Ice and elevating your arm at rest may also be advised to help with swelling and pain.
    When your child is ready, exercises may be advised to reduce stiffness and improve range-of-motion. Your child should not return to activities or sports until their doctor gives them permission to do so.

    Prevention

    To help reduce the chance of a fracture, have your child:
    • Wear proper padding and safety equipment when participating in sports or activities
    • Always wear a seatbelt when riding in a car
    • Avoid activities that may result in falling

    RESOURCES

    Kids Health—Nemours Foundation http://kidshealth.org

    Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Foundation http://www.canorth.org

    Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca

    References

    Buckle fracture of distal radius. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114297/Buckle-fracture-of-distal-radius. Updated February 10, 2017. November 10, 2017.

    Forearm fractures in children. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00039. Updated October 2014. Accessed November 10, 2017.

    Solan MC, Rees R, et al. Current management of torus fractures of the distal radius. Injury. 2002;33(6):503-505.

    Wright E. Treating buckle fractures in children with removable splints. Nurs Child Young People. 2011;23(10):14-17.

    Revision Information

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