• Reference Number: HEY1069/2022
• Departments: Orthopaedics, Paediatrics, Physiotherapy
• Last Updated: 30 September 2022

Introduction

This leaflet has been produced to give you general information about your child’s injury. We understand you may not have seen a clinician face to face in fracture clinic however, most of your questions should be answered by this leaflet.  If after reading it, you have any concerns or require further explanation, please do not hesitate to contact the fracture clinic team. Contact details are available at the end of this leaflet.

What is a buckle fracture of the radius?

The x-rays your child had following your injury show that they sustained a broken wrist bone. A broken bone may also be referred to as cracked or fractured – these terms mean the same thing.

A buckle or torus fracture is a minor fracture, which occurs in children’s bones. These fractures heal quickly, by themselves.

How should it be treated?

This injury can be treated simply in a wrist splint for up to 3 weeks. The splint is used to reduce any pain your child may be experiencing and can be worn at night.

Sometimes these fractures settle down quicker than 3 weeks and, if it is not too sore, it is fine for them to start taking the splint off sooner. Start by taking it off for short periods of time, and at night, and wean off gradually.

The splint can be removed for washing and dressing. Some younger children will not keep their splint on but do not worry they will use their arm as much as their pain allows and will limit themselves. Any rough play should be discouraged.

Your child can go to school but should wear the splint as directed above. Your child should not take part in any physical education (PE), sport or rough activities for 6 weeks.

How can I help my child in the first few days?

Controlling the pain and swelling by following the principles of RICE are important:

R   REST

Complete rest is not advisable. Your child should be encouraged to use the fingers and hand whilst in the splint for simple everyday tasks such as using knife and fork.

I    ICE

Ice will help reduce the pain in your child’s wrist and so should be applied for 10 – 15 minutes every 2- 3 hours. This will also help to reduce any swelling.

There are many different ways in which ice can be applied however crushed ice, in the form of frozen peas for example, is the most effective. Whichever method you choose it is important that you wrap the ice in a damp towel, in order to prevent it from ‘burning’ the skin.

• Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold
• Do not apply ice to an open wound
• Do not apply an ice pack to an area that has poor circulation
• When you apply ice to your skin, check the skin every five minutes and stop using it if:
• the area becomes white, blue or blotchy
• the area becomes excessively painful, numb or tingles

C   COMPRESSION

The splint will provide some compression however if your child develops any signs of poor circulation such as tingling, numbness, blueness of the skin of the foot and increasing pain the splint should be removed.

E   ELEVATION

If your child has swelling in their wrist or hand advise them to sit on a chair and place their elbow on cushions so that it is level or slightly higher than their shoulder. In this position, ask them to point their hand towards the ceiling and open and close their hand slowly for 10 minutes.  This will help to reduce any swelling further.

What exercises should my child do?

Whilst in the splint, it is important your child tries to use their wrist and hand as normal when doing everyday tasks like washing, dressing and eating.

Arm exercises are very important. Your child should be encouraged to move their elbow, hand and fingers as soon as they can. The wrist splint can be removed from day one to allow the child to move the wrist for a couple of minutes and then it should then be put back on. Some exercises they should try are described below.

1. Rest your forearm on a table with your hand over the edge. Using your wrist only, move your hand down towards the floor.

Hold the stretch for 10 seconds.

Now move your hand towards the ceiling. Repeat 10 times each direction

2.  Sit with your elbow tucked in by your side and your thumb upper most. Now keeping your thumb upper most move your fingers down towards the floor. Hold 10 seconds.

Next move your fingers back up towards the ceiling. Hold 10 seconds.

Movement should occur at the wrist only

3. Bend your elbow and tuck it into your side.

Turn your palm as far as possible upwards without moving your elbow. Feel the stretch and hold for 10 seconds.

Now turn your hand back over so your palm faces downwards, feel the stretch and hold for 10 seconds.

4. Support your elbow on a table with your wrist straight and fingers pointing towards the ceiling.

Bend your fingers into your palm as tightly as you can and feel them stretching. Hold the stretch 10 seconds.

Now stretch your fingers as wide as you can and feel them stretching. Hold the stretch for 10 seconds.

All photos with kind permission of ©Physiotec™

Many children often get back to normal without the need for specific exercises. If however you notice your child is not moving the wrist fully the exercises will help encourage them to regain full function, flexibility and strength.

They should be practiced 10 times, 3 to 4 times per day. Your child may experience more discomfort when they start the exercises, however this is normal and does not mean they should stop.  If their symptoms remain worse for more than two hours after the exercises, then they should decrease the number of each exercise that they do and build up again slowly.

When should my child start increasing their activity?

Repetitive wrist and hand movements and lifting objects heavier than a cup of water should be avoided to begin with.  However, as your child’s movement improves and pain reduces, little by little they can increase the amount of weight that they are able to lift.  Progressing quickly from lifting a cup of water to a heavy school bag for example would not be advisable, as is likely to result in overloading of the soft tissue and could consequently lead to a delay in recovery.

If your child participates in an active hobby then it is advisable that they do not return to this until they have full strength and full range of movement.

If they play a sport, they can practice sports specific activities; like throwing or catching. Build up these exercises gradually from around 6 weeks, in order to help regain strength and flexibility, before returning to full training sessions and competition.

Does my child require a follow up?

Your child does not require a follow up appointment and they have been placed on a Patient Initiated Follow up (PIFU) pathway. This means they will not have another appointment to be seen in fracture clinic.

If, however they have any problems or further queries relating to this injury within the next six weeks, you can contact us on 01482 674378 during clinic hours 9.00am – 4.30pm Monday to Friday. Please do not choose an option and when prompted leave a message if there is no answer and we will aim to get back to you within the same working day. After six weeks your child will be discharged and should seek advice from your GP.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you need information about your child’s (or a child you care for) health and wellbeing and their care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.