Buckle Fracture: Treatment and Recovery

A buckle fracture is an incomplete fracture where one side of the bone "buckles" or bends on itself; it does not affect the other side of the bone. This type of fracture can occur throughout childhood but is most common between the ages of 7 and 12 years old.

Falling on their outstretched hand is a common way that kids get buckle fractures. For example, if a child gets thrown off their bike or trips while running and breaks the fall with their hand, the force of landing on it can cause a buckle fracture.

This article discusses why children get buckle fractures. You'll also learn how buckle fractures in kids are diagnosed and treated.

What Are Buckle Fractures?

Buckle fractures are one of two common incomplete fractures that kids get.

• Buckle fractures: Considered a "compression" injury because the side of the bone under compression crunches down on itself, causing the bone to crumple on just one side.
• Greenstick fractures: Considered a "tension" injury because the bone is pulled too far on one side. The bone on the greenstick side of the injury is pulled apart rather than being compressed on itself in a buckle fracture.

Adults don't usually get buckle fractures because their bones are less elastic than kids' bones. Because a child's bones are softer and more flexible, they can withstand more compressing force, which is why "incomplete" fractures occur. An adult bone is more like a porcelain plate that cracks all the way through when it fails.

Where Do Buckle Fractures Happen Most?

Buckle fractures occur most often in the forearm (radius and ulna), near the wrist, as a result of a child falling on their hands. However, buckle fractures can happen on other long bones, including:

• Femur (thigh bone)
• Tibia and fibula (lower leg bones)
• Humerus (upper arm bone)

Signs and Symptoms of Buckle Fractures

The most common symptoms of a buckle fracture are pain and swelling. Other signs of a buckle fracture may include:

• Tenderness with pressure or movement
• Bruising of the skin
• A deformity or bump at the location of the fracture
• A child not wanting to use the injured body part

What Causes Buckle Fractures?

Buckle fractures are most commonly caused by kids falling and trying to catch themselves with outstretched arms, landing on their hands. The force of the fall compresses their lower arm bone, causing a buckle fracture.

How Buckle Fractures Are Diagnosed

A healthcare provider can diagnose a buckle fracture by looking at your child's injury, asking you about their symptoms, and identifying what they were doing when they got hurt. Your healthcare provider may also order medical imaging tests like X-rays.

How Buckle Fractures Are Treated

Treatment of a buckle fracture usually involves placing a splint on the injured limb. The goal is to ensure that the injured part of the body is immobilized (unable to move) for about three or four weeks so it can heal. Buckle fractures do not require surgery.

Studies have compared casting to splinting for buckle fractures, and it appears that one treatment is not really any better than the other.

Here are some things to consider about a cast for a buckle fracture:

• The advantage of a cast is that it protects the injured area very well. Kids who wear a cast seldom complain of pain, and the bone is well protected even when they're active.
• Unlike a splint, kids cannot remove the cast, which eliminates the worry about your child not sticking with the treatment until the end.

Here are some things to consider about a splint for a buckle fracture:

• The advantage of a splint is that it is a simpler, more flexible treatment than a cast. Splints can be removed for bathing and washing, and caregivers can take off the splint themselves once healing is complete.
• However, splints need to be worn consistently to work. A downside of a splint treatment for a buckle fracture is that many children just take them off. Without the splint, a child may have pain and healing will take longer.

Deciding on the best treatment for a buckle fracture depends on the injury, the comfort of the child, and the caregiver's wishes.

How to Prevent Buckle Fractures

Although falls can't always be prevented, there are some safety steps parents and caregivers can take to reduce the risk of injury:

• Make sure your child always wears a seatbelt.
• Use protective equipment for certain activities and sports.
• Keep your home free from clutter that could result in tripping.
• Don't allow children to stand on chairs, tables, or countertops.
• Be sure your child is getting enough calcium and exercise to strengthen bones. Weight-bearing exercises, such as jumping rope, jogging, dancing, and walking can help develop and maintain strong bones.

Buckle Fracture Recovery and Long-Term Effects

The success of the treatment will depend on how well a child is able to follow the plan until the injury is healed.

How Long Does a Buckle Fracture Take to Heal?

Buckle fractures typically heal more quickly than greenstick fractures. If your child plays sports, they will need to wait until their provider gives them the "OK" to return to play. That might mean sitting on the bench for a while. High-risk activities such as contact sports, or anything with a high risk of falling, should be avoided after injury for a period of up to two months to prevent further injury.

Do Buckle Fractures Cause Long-term Issues?

Most buckle fractures heal completely with no long-term problems. They are not linked to later joint or bone conditions like arthritis. Buckle fractures are not significantly displaced and are not growth plate fractures, so they won't affect the long-term health of a child's bone.

Nearly all buckle fractures are normal childhood injuries, caused by normal childhood activities. They are not breaks that happen because of an underlying problem with a child's bones or disease.

However, if your child gets a buckle fracture with no known injury or they have more than one buckle fracture, talk to a healthcare provider about it. They might want to do some tests to check your child's bone and overall health.

When to See a Healthcare Provider

If your child shows symptoms of a buckle fracture, see a healthcare provider as soon as possible to have the injury evaluated. Go to the emergency room right away if they've had a trauma or experience any of these symptoms:

• Intense pain
• Inability to move a part of their body
• A part of their body is noticeably different looking or out of its usual place
• Excessive swelling
• New bruising that appears at the same time as any of these other symptoms

Summary

A buckle fracture is a common injury in children. Most buckle fractures will get better as long as they are given time to heal. Your child may need to wear a cast or splint for several weeks if they have a buckle fracture. Buckle fractures do not require surgery.

Buckle fractures are not typically a sign that there is something wrong with your child's bone health and they don't usually lead to any long-term joint or bone problems.