The American Academy of Orthopaedic Surgeons notes wrist fractures account for 30 percent of children's fractures. Buckle fractures, which are also called torus fractures, are a specific type of fracture that only happens in children. Buckle fractures are the most common wrist fracture in children.
Children's Bones
Long bones in the forearm develop from growth plates located near the end. The growth plates are an uncalcified cartilage area where the cells are rapidly dividing. On X-rays, the growth plate is a clear area extending across the bone. The bone grows in length and width from the growth plates. The bone is surrounded by a fibrous tissue called the periosteum.
Wrist Anatomy
The wrist is composed of two long bones: radius and ulna. The radius is underneath the thumb and the ulna is on outside of the arm. Eight small carpal bones move across the radius and ulna creating wrist flexion, extension and deviation. Turning the hand rotates the radius around the ulna near the elbow.
The volar surface of the wrist is the inner side or palm side, while the dorsal wrist surface is the outside of the arm.
Buckle Fracture
Buckle fractures occur when the child lands on an outstretched hand. Children complain of wrist pain and refuse to use the arm. The child may identify one area of the wrist as the most painful. The arm is not obviously deformed.
The bones compress creating a "buckle" or bump on the dorsal surface of the bones, which can be seen on an X-ray. The opposite side of the bone appears normal.
Similar Fractures
Several other fractures of the wrist can occur in children. Greenstick fractures cause the bone to bend on the opposite side. A Galeazzi fracture of the radius has both sides of the bone broken and the ulna may be displaced. Both bone fractures may have fracture ends displaced. Growth plate fractures, which are also called physeal or Salter fractures, go through part of the growth plate.
Treatment
The arm may be put in a cast for three to six weeks. Some doctors prefer to splint the wrist. No difference in healing of wrist buckle fractures has been seen between casts and splints. As children's bones grow, they remodel. In a year there should be no sign of the fracture.
