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The most common buckle fracture is that of the radius, and this happens most commonly in children rather than adults. Due to the structure of adult bones, buckle fractures rarely happen in fully developed bones. Broken bones can happen at any age, but not only are they far more likely to happen to children, but they should be taken seriously in children, too, since their bones are still developing. So exactly what is a buckle fracture?
What Is A Buckle Fracture?
Also known as a torus fracture, a buckle fracture refers to a compression bone fracture that doesn't break all the way through the bone. Typically, this type of break happens in the long bones like the radius of the arms or the tibia of the legs.
Not to be confused with a greenstick fracture, which refers to a bone break from too much tension pulling the bone to one side, a buckle fracture occurs when the bone is crushed. Unlike a full break, this is still usually considered a stable fracture where you don't usually have to worry about the pieces of bone shifting out of place.
Buckle fractures don't show up in adults too often. Adult bones are fully developed, which means they are better able to resist buckle fractures. If an adult's bone does break, it is normally a full break or fracture. Children's bones are quite different; not only in how they break, but also in how they heal.
Children's Bones vs Adult Bones
Because children's bone are still developing, there is less to rebuild when a child's bone breaks. In terms of recovery time for broken bones, children take weeks to heal while adults can take months (sometimes even years) to fully recover from a bone fracture. The typical recovery time for a buckle fracture in children is about three to six weeks. However, the recovery time often depends on the bone injured, the severity of the injury, and how quickly it is treated.
One of the main differences between children's bones and fully developed bones are the growth plates. These growth plates are often found at the end of long bones, where bone fractures, especially buckle fractures, are likely to occur.
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Growth Plates
Each long bone has at least two growth plates in children and adolescents, both of which are in either end of the bone. These growth plates determine the shape and size of the bone when it fully develops. Bone fractures often occur in these areas because they are weaker than the other areas of the bone until the individual matures and the spongy, cartilage-like material is replaced with hard, dense bone.
If the growth plates were affected by the fracture, you may be recommended to a specialist and special treatment (like surgery) may be needed.
Causes of Buckle Fractures
Because children are still growing, their bones are softer, with the insides of the bones being a hard cartilage rather than solid bone. Buckle fractures are often caused by too much pressure. When the bone finally breaks, it is often not a simple break clean across the bone. Instead, the bone bends and cracks only part of the way. When a buckle fractures occurs whether in children or adults, it is most often at the radius near the wrist and is usually caused by a fall. Osteoporosis is a known contributor to bone fractures in adults.
Symptoms of a Buckle Fracture
Just as with any type of broken bone, swelling and bruising is likely with a buckle fracture. The injured arm or leg will also be tender and painful when touched or moved. Sometimes the arm or leg can also look slightly bent in an unnatural way. There will not be any broken skin as there is in a compound fracture.
When bearing weight on the injury, it will hurt a lot. If this happens, don't put any weight or pressure on it as it will only make the injury worse. Once you or your child are with a doctor, the doctor will perform a physical exam and diagnose a buckle fracture using scans, such x-rays or MRI, if necessary.
What Is A Buckle Fracture: How It Is Treated
The doctor is looking for the type of fracture, its location, the size of the injury, and how surrounding bone and soft tissue was affected. All of these factors will determine how to best handle treating the buckle fracture. As expected, a splint or cast will probably be required. Regardless of the age of the patient, starting treatment right away is crucial to a proper and speedy recovery.
Immediately after a bone breaks, a blood clot forms around the bone as it begins healing itself. If the healing process starts before diagnosis, or if the bone was angled by the break, the doctor will have to reset the bone. Depending how long ago it was broken and how bad of an angle it is at, this procedure can be done with or without general anesthesia.
Using A Splint and/or Cast
Sometimes the doctor will initially apply a splint until the swelling has gone down enough to properly apply a cast. For an injury like a buckle fracture, the cast may only be needed for three or four weeks.
Once the cast is removed, joints of the affected limb will be sore and stiff. This can last for as long as two weeks and physical therapy usually isn't required. However, for a couple of weeks following the removal of the cast, the patient should avoid rough play and being too physically active. The doctor may also schedule follow-up sessions to see how well the bone is healing.
Surgery
Although it is not common for a buckle fracture to require surgery, it can be performed to put broken bones back in their proper place using implants, along with removing any bone shards that may have embedded into the surrounding soft tissue.
If surgery is required, there will probably be a longer recovery period and additional follow-up sessions to ensure the injury is healing properly.
What Is A Buckle Fracture: Recovering At Home
Regardless of whether a cast or splint is used, patients can expect the pain and swelling to last the first several days. The doctor may prescribe something for the pain. Also, try to elevate the injured limb on a pillow. Keeping it above your heart can help reduce swelling. Also, applying ice can also help any pain or swelling.
Patients with a broken arm should keep it in the sling whenever possible. Patients with a broken leg should keep off it as much as possible, even if given a walking boot. During the healing process the bone should be left immobilized.
Living With A Cast
It is important to wrap the cast in plastic so no moisture gets in it when bathing or icing the injury. This is where a removable splint has its advantages. If the cast gets wet, it will weaken the structure and thus its ability to keep the bone straight. Use an elastic band to secure a plastic bag around the cast while showering.
Within the first few days the cast can get itchy, but it is important to not use any powders or lotions in the cast as this is likely to cause sores to develop under the cast where they can't be seen. We know it can be very uncomfortable to wear a cast for such a long time, especially for children. Talk to your child's doctor about what to expect while wearing the cast and ask about ways to avoid any discomfort. The discomfort generally only lasts for the first two days or so.
Fractures well cured make us more strong.-Ralph Waldo Emerson
If it truly becomes unbearable, talk to your doctor about using a hair dryer without heat. One way of handling an itchy cast involves using a hair dryer with a cold setting. (Using any heat around the cast is likely to cause the skin inside of the cast to become drier and itchier.) Also, consider exercising any joints that are outside of the cast to improve circulation.
Seek medical attention if the cast feels too tight, especially after being elevated after 24 hours or the patient's toes/fingers turn blue. If there are any other problems with the cast, cracks or breaks, or if it feels too loose or it smells funny, then it should be replaced by your doctor as soon as possible.
Physical Therapy
It is not always required, but if your child used a cast vs a splint, he/she will likely have some weakness and stiffness. Talk to your doctor about exercises and stretches your child can do to build back their strength and flexibility.
Most cases of buckle fractures are treated successfully without any complications or long-term problems. Now that you know what is a buckle fracture and how it is treated, you will be better prepared if an accident ever does happen.
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