To maintain confidentiality, we will refer to this patient as Max, who is a paediatric patient of Orthotics Plus who sustained a distal radius buckle fracture.
This type of fracture is common in children due to the flexibility of their bones, which makes them less prone to breaks but more susceptible to buckling.
Rather than a break, a buckle fracture results in a compressed area of bone, with indentations and raised areas visible on an x-ray.
Orthotics Plus supported Max to full recovery and this article is an account of the treatment.
Complications When Managing Paediatric Wrist Fractures
This consideration is not limited to buckle fractures but applies to all types of fractures, especially in paediatric patients.
Specifically, we must take note of whether the fracture extends into the joint line or growth plate.
What is a growth plate?
A growth plate, also known as an epiphyseal plate, is a layer of cartilage near the ends of long bones in children and adolescents.
It is responsible for bone growth and helps to determine the size and shape of maturing bones.
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As a child grows, the growth plate gradually turns into solid bone, marking the end of bone growth.
Because the growth plate is still developing and is more fragile than mature bone, it is more prone to certain types of injuries, such as fractures that can disrupt normal bone growth.
How do Orthotics Plus manage these cases?
When there is involvement of the growth plate, we refer the patient to an orthopedic specialist to ensure optimal management.
This may still involve the use of a cast or splint, but we seek the specialist’s guidance in confirming the most appropriate approach.
Injury, Acute Management and Transport to Orthotics Plus
Max sustained his fracture from a fall from monkey bars, which is quite a common cause of injury.
The parents contacted Cabrini Emergency Department and could transport Max in the car, and did not require an ambulance.
Max visited the hospital for an X-Ray and temporary back-slab and was referred to Orthotics Plus for same-day fracture management services.
The X-ray was consented to be sent to our Malvern clinic to be available upon arrival.
The role of a back slab
A back slab is a temporary splint made of plaster or fiberglass that is applied to the injury site.
It provides support and protection to the injured area, but unlike a full cast, it does not completely encase the limb. This allows for swelling and further adjustments to be made as needed during the treatment process.
A back slab may be used as an initial treatment for certain types of fractures, or as a transitional treatment before a full cast is applied.
Treatment at Orthotics Plus
The back slab was carefully removed and the patient’s arm was positioned with the elbow on the table, commonly referred to as the “arm wrestle position”.
The patient was treated with compassion and care, and did not experience any exaggerated pain during the appointment.
Subsequently, a waterproof cast was applied to the affected limb.
Returning to activity
We advised the patient to avoid weight-bearing activities, lifting and activities that pose a risk of falling onto the injured arm, like trampolining or bike riding.
Most sports are to be avoided, but patients may be able to participate in light activities in non competitive settings.
Physical therapy to assist recovery and rehabilitation
There are currently no recommended exercises or physical therapy while Max was in the cast, as immobilisation is necessary during the initial healing period.
However, after the cast is removed, people may require appropriate Physiotherapy or hand therapy to regain full function in terms of strength and range of motion.
This is less common in paediatric patients as they recover more quickly than adults and rehabilitate incidentally with play and normal life.
Advice Regarding Potential Pain or Discomfort
We explained that it’s normal to feel tightness when a cast is applied, but in rare occasions, swelling or discoloration of the hand are concerning and may require the cast to be split or removed.
To address swelling, patients are advised to elevate their arm.
The waterproof cast allows for swimming and showering, but patients should be aware that water can flow in and out, and will need to wrap a towel around the hand to prevent water on the floor and the risk of falls.
How Long to Recovery After a Buckle Wrist Fracture
Patients are typically advised on the timeframe for cast removal by their GP or specialist, which is typically around 3 to 4 weeks, but 4 weeks is often recommended.
After cast removal, it’s recommended to avoid contact sports for an additional 2 weeks.
Check X-rays are only necessary in rare cases of an unusual fracture.
Max’s Recovery After The Distal Radius Fracture
The cast was removed at the recommended time by the GP, and the patient’s family provided positive feedback regarding the convenience of the waterproof cast.
They found it easier to manage without the need for plastic bags and appreciated the ability for the patient to shower and swim without interruption.
The family was especially pleased that they were able to enjoy their holiday in Queensland without any restrictions on activities and Max was able to swim in the pool and ocean.
Max went on to experience a full recovery of his wrist, how great!
Need Fracture Support in Melbourne?
At Orthotics Plus, we are committed to providing professional care for patients with fractures. If you or someone you know needs assistance with fracture management, we would like you to know that
- Our university-trained staff are available for appointments across multiple locations in Melbourne
- We are experts and highly experienced in fracture management
- We offer same-day and after hours service
- We are supported by a friendly, caring Administration team
Please view our fractures page for more information and contact our clinics with your enquiry today.