A buckle fracture, also known as a torus fracture, is a common and stable type of break, often sustained by children. This incomplete injury typically involves the radius, one of the two forearm bones, near the wrist joint. It is considered a minor injury that heals reliably without long-term issues.
Understanding the Buckle Fracture
A buckle fracture is a compression injury where the bone sustains a force that causes it to bulge outward. The break does not extend completely through the bone; the opposite side of the cortex often remains intact, making the injury inherently stable. Buckle fractures are overwhelmingly seen in children under the age of 12. Their bones are softer and more pliable, making them susceptible to bending rather than snapping entirely. The injury most frequently occurs when a child falls onto an outstretched hand, driving a compression force up the forearm.
Treatment Options and the Role of Casting
The stability of a buckle fracture means a traditional, rigid cast is typically not necessary for healing. The primary goal of treatment is to control pain and protect the injury site from further impact, not to maintain alignment. Less restrictive immobilization methods are effective and preferred, such as a pre-fabricated wrist splint, a soft cast, or a removable backslab. These alternatives provide sufficient protection while offering advantages over a full cast, such as greater comfort and ease with daily activities like bathing. A full cast might be considered in rare instances, such as when the fracture has unusual displacement or involves the growth plate.
Healing Time and Post-Treatment Care
Recovery from a buckle fracture is relatively quick. The typical immobilization period with a splint or soft cast is generally three to four weeks. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, are usually sufficient for pain management during this time. Follow-up appointments and repeat X-rays are often not required after the initial diagnosis, though some protocols recommend a check-up around the three-week mark. After the device is removed, the child’s wrist may feel stiff or slightly weak; gradual return to activity is encouraged, but strenuous activities should be avoided for a total of approximately six weeks. Seek immediate medical attention if there is any sudden increase in pain, new numbness, or significant swelling after the initial treatment.