Podcast 834: Peds Buckle Fractures

Emergency Medical Minute

Contributor: Aaron Lessen, MD

Educational Pearls:

• Torus (Buckle) fractures are a commonly encountered pediatric fracture pattern
• Typically presents as wrist pain secondary to a child falling on outstretched hand
• One edge of the bone “buckles” or bends because children’s bones are softer and more pliable
• Management
• Older studies have shown that short term immobilization with a velcro splint and primary care follow up is sufficient
• Recent randomized trial compared immobilization with Velcro splint with as needed wrist support using a gauze wrap
• No significant differences noted in outcomes between the two cohorts
• Physicians can consider using an ace or gauze wrap as needed for buckle fracture management along with OTC analgesics for pain management

References

Asokan A, Kheir N. Pediatric Torus Buckle Fracture. StatPearls. StatPearls Publishing

Copyright © 2022, StatPearls Publishing LLC.; 2022.

Kennedy SA, Slobogean GP, Mulpuri K. Does degree of immobilization influence refracture rate in the forearm buckle fracture? J Pediatr Orthop B. Jan 2010;19(1):77-81. doi:10.1097/BPB.0b013e32832f067a

Perry DC, Achten J, Knight R, et al. Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. Lancet. Jul 2 2022;400(10345):39-47. doi:10.1016/s0140-6736(22)01015-7

Summarized by Mark O’Brien, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD

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