Hospital &lt;I&gt;versus&lt;/I&gt; home management of children with buckle fractures of the distal radius

Symons, S.; Rowsell, M; Bhowal, B.; Dias, JJ

doi:10.1302/0301-620x.83b4.11211

Cited by 67 publications

(19 citation statements)

References 3 publications

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“…However, this classification does not make the distinction between the buckle (torus) and the greenstick fracture of the distal radius. It is generally agreed that these two common pediatric fracture types are different entities which behave differently and need different treatment and follow up [18,24,25,36,37]. In addition, the AO group has added ligamentous avulsion injuries of the wrist as a separate category.…”

Section: Discussionmentioning

confidence: 99%

Classification of distal radius fractures in children: good inter- and intraobserver reliability, which improves with clinical experience

Randsborg

Sivertsen

2012

BMC Musculoskelet Disord

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BackgroundWe wanted to test the reliability of a commonly used classification of distal radius fractures in children.Methods105 consecutive fractures of the distal radius in children were rated on two occasions three months apart by 3 groups of doctors; 4 junior registrars, 4 senior registrars and 4 orthopedic consultants. The fractures were classified as buckle, greenstick, complete or physeal. Kappa statistics were used to analyze inter- and intraobserver reliability.ResultsThe kappa value for interobserver agreement at the first reading was 0.59 for the junior registrars, 0.63 for the senior registrars and 0.66 for the consultants. The mean kappa value for intraobserver reliability was 0.79 for the senior registrars, 0.74 for the consultants and 0.66 for the junior registrars.ConclusionsWe conclude that the classification tested in this study is reliable and reproducible when applied by raters experienced in fracture management. The reliability varies according to the experience of the raters. Experienced raters can verify the classification, and avoid unnecessary follow-up appointments.

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Section: Discussionmentioning

confidence: 99%

Classification of distal radius fractures in children: good inter- and intraobserver reliability, which improves with clinical experience

Randsborg

Sivertsen

2012

BMC Musculoskelet Disord

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“…Less requirements are needed for buckle fractures that are shown to be more stable than greenstick fractures [ 23 ]. For this reason, buckle fractures should be treated with a well-molded below-elbow cast or with the use of a removable wrist immobilizer for 3 weeks, which provides increased early functionality [ 24 ].…”

Section: Conservative Treatmentmentioning

confidence: 99%

Management of pediatric forearm fractures: what is the best therapeutic choice? A narrative review of the literature

et al. 2020

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Purpose This narrative review intends to summarize the most important and relevant data on diagnosis and treatment of pediatric forearm fractures and to describe the characteristics and advantage of each therapeutic option. Methods We conducted a literature research considering peer-reviewed papers (mainly clinical trials or scientific reviews) using the string “forearm fracture AND epidemiology” or “forearm fracture AND diagnosis or “ forearm fracture AND treatment” or “forearm fracture AND casting” or “forearm fracture AND surgery”. Studies were identified by searching electronic databases (MEDLINE and PubMed) till April 2020 and reference lists of retrieved articles. Only English-language articles were included in the review. Results Conservative management with cast immobilization is a safe and successful treatment option in pediatric forearm fractures. Surgical indication is recommended when an acceptable reduction cannot be obtained with closed reduction and casting. Surgical treatment options are intramedullary nail, plating and hybrid fixation. Conclusions There is not a unique consensus about fracture management and treatment. Further studies are necessary to create univocal guidelines about optimal treatment, considering new techniques and available technologies.

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“…Many authors consider buckle fractures to be stable (Farbman et al 1999, Symons et al 2001, Solan et al 2002), but one study reported 7% subsequent displacement among buckle fractures (Schranz and Fagg 1992). Greenstick fractures are less stable.…”

Section: Introductionmentioning

confidence: 99%

Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures

Randsborg

Sivertsen

2009

Acta Orthopaedica

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Background and purpose Numerous follow-up visits for wrist fractures in children are performed without therapeutic consequences. We investigated the degree to which the follow-up visits reveal complications and lead to change in management. The stability of greenstick and buckle fractures of the distal radius was assessed by comparing the lateral angulation radiographically.Patients and methods The medical records of 305 distal radius fractures in patients aged less than 16 years treated at our institution in 2006 were reviewed, and any complications were noted. The fracture type was determined from the initial radiographs and the angulation on the lateral films was noted.Results Only 1 of 311 follow-ups led to an active intervention. The greenstick fractures had more complications than the buckle fractures. The lateral angulation of the buckle fractures did not change importantly throughout the treatment. The greenstick fractures displaced 5° on average, and continued to displace after the first 2 weeks. On average, the complete fractures displaced 9°.Conclusion Buckle fractures are stable and do not require follow-up. Greenstick fractures are unstable and continue to displace after 2 weeks. Complete fractures of the distal radius are uncommon in children, and highly unstable. A precise classification of fracture type at the time of diagnosis would identify a smaller subset of patients that require follow-up.

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Hospital <I>versus</I> home management of children with buckle fractures of the distal radius

Cited by 67 publications

References 3 publications

Classification of distal radius fractures in children: good inter- and intraobserver reliability, which improves with clinical experience

Classification of distal radius fractures in children: good inter- and intraobserver reliability, which improves with clinical experience

Management of pediatric forearm fractures: what is the best therapeutic choice? A narrative review of the literature

Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures

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