Buckle fractures of the distal radius

What is a buckle fracture?

A buckle fracture occurs when one side of the bone bends or is compressed (or ‘squashed’) but the other side remains intact. Buckle fractures are common in children because their bones are softer than adult bones. This makes them more likely to compress, rather than suffer a complete break, after an impact.

What treatment is needed?

Like sprains, buckle fractures heal well by themselves without causing any long-term problems. We do not routinely treat these injuries with a plaster cast.

Many children manage well without any kind of wrist bandage or splint. However, if your child feels more comfortable with one, they can wear it until they feel able to use their wrist again with ease. The bandage or splint can be removed when the child needs to wash, and the skin should be thoroughly dried before putting the bandage or splint back on again.

A large scientific study that took place throughout the UK, called the FORCE study, looked how best to treat buckle fractures. This study showed that children who were offered a bandage (which many of them chose to wear) healed well and were equally as comfortable as those who were treated in a hard splint or cast.

Why does my child need to wear a splint?

The specific type of fracture that your child has does not need to be treated in a plaster cast. Instead, wearing a wrist splint will help to reduce pain and keep the wrist in a comfortable position.

When can my child use their wrist and hand again?

Most children start to use their wrist and hand comfortably again by 2 weeks. They should be allowed to use their hand as much as they want, but should not do anything that causes them pain or discomfort. If your child wears a bandage or splint on their wrist then this should be removed whenever the wrist becomes more comfortable – and certainly by 3 weeks.

Your child can return to sporting activities, physical exercise and rough play as soon as the pain and discomfort settles.

Can the splint be removed for washing?

The splint can be removed to allow your child to wash. It is important that the skin is thoroughly dried before the splint is put back on.

Will it be painful?

The injury can be very painful at first. Pain relief like paracetamol and ibuprofen should be given if needed. The splint will help to keep the wrist in a comfortable position. Pain relief like Paracetamol and Ibuprofen should be given if needed. If your child is having significant pain despite this medication, you may need to return to the Emergency Department where we can assess to see if a splint may help, if they do not have one already. If they are already wearing a splint and are still having lots of pain, we may at that point consider a plaster cast.  

Are there any other symptoms to look out for?

The wrist may become swollen and bruised and this will gradually settle as healing takes place. If you are concerned about severe swelling, uncontrollable pain, abnormal movement of your child’s fingers, or if the fingers are very pale and cold compared to the other side then please return to the Emergency Department for advice.

Do we return for an appointment?

We know that 99% of these fractures heal without any problems and so we do not make routine follow up appointments. If you have any concerns then please see your GP or return to the Emergency Department for advice.

Reviewed by Dr L Sabir in February 2023, next review in February 2025. 

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