What is Buckle Fracture
Buckle fracture is also called as torus fracture wherein it affects a side of the bone however it does not fully break although the side of the bone bends outward. The word “torus” comes from the Latin word “tori” which means swelling or what is called protuberance. This is a type of incomplete fracture which is often compared with the greenstick fracture where when one side of the bone breaks the other bends outward. However the difference with the two is that in buckle fracture it does not bow out.
This kind of fracture is usually common in children especially when the bones are growing. Compared with the adult fracture, the bones of a child are soft. This kind of fracture normally heals within a month or so however it is best to consult the doctor first before doing any treatment.
X Ray Image 1 : A buckle fracture of the distal end of the radius.
Picture source : wikipedia
X Ray Image 2 : Buckle fracture
Picture source : medical-definitions.com
Different types of Bone Fracture:
This is a kind of fracture wherein there is a complete breakage of the bones or the bones cracked through and through. The breaks of the bones are often in straight lines.
The bones are broken up into smaller pieces and usually the fragments of the bones are unaligned.
These are also called as impacted fractures where the breakage of the bones is mostly secondary to the disease process. This is mostly related to problems like osteoporosis, running in long distance and others.
In this condition, the bone is not completely broken. It is also called as the greenstick fracture and small fissures are seen on the bones but it does not completely break.
A kind of fracture here in the bone that is broken is exposed to the skin. The bone punctures or skin from the inside-out but then it retracts back. This is also called as the open fracture and the risks of infection are higher because bacteria, viruses and others can enter the punctured skin.
Buckle fracture of the radius
This kind of buckle fracture is common in children where according to statistics about 50% of the child-related fracture cause is the radius buckle fracture. This is because children are carefree and they seem to fall a lot. When they fall as they jump, run or play their arms are outstretched. The usual treatment done by orthopedic doctors include casting or splinting.
Buckle fracture ulna
The forearm is composed of 2 bones which are the ulna and radius. This is also a common site for buckle fracture especially amongst kid when they play and fall down and in elderly as well because their bones are fragile.
Buckle fracture wrist
One of the common problems or conditions in the wrist is the buckle fracture. This is another common site for buckle fracture because when a person falls, the hands are extended for support upon falling causing the wrist to break.
Buckle fracture finger
Buckle fracture can also happen in fingers although it is not as serious and as common as the other types of buckle fracture. This will certainly prevent the range of motions in the finger especially the fine motor movements. The person with finger buckle fracture is expected to wear a splint or cast to help immobilize the affected area.
Symptoms of Buckle Fracture
Having a buckle fracture in any parts of the body mostly happens to children and elderly. There is a great risk for children because their bones are soft and still developing. On the other hand, an elderly is also at risk because their bones are fragile and can easily break. The main cause of this kind of fracture is mostly when falling. Some of the symptoms experienced include:
- Swelling or bruising
- Uncomfortable feeling when moving the affected area
Diagnosis for Buckle Fracture
The most common form of diagnosing a buckle fracture is through x-ray. This is an imaging diagnostic test which can see what happens to the bones and see the severity of the injury. If the x-ray result does not give definitive results, other diagnostic tests such as the CT scan (computed tomography scan) or MRI or magnetic resonance imaging may also be opted.
Treatment for Buckle Fracture
It is very important to consult an orthopedic doctor before doing any treatment for buckle fracture. These doctors specialize in treating various bone problems. Naturally, the bones heal by itself as part of its proliferative process. There are different phases in bone healing. These are the reactive of the inflammatory phase, the reparative phase and the remodeling phase.
The reactive phase
This occurs when there is an inflammatory process. There is also a blood clot that surrounds the area which takes part in making the bones more stable as it heals back.
In this phase there is a cartilage or the callus formation which is replaced after the inflammation process. Then after a few weeks, the formation of the hard bone or the callus formation occurs.
The remodeling is the final phase where the bone goes back to its former shape. The blood circulation in affected area also improves which helps in the adequacy of the bone healing process.
There are 3 main treatments for bone fractures. These include pain management, immobilization and surgery if needed.
Pain is felt as soon as there is fracture and it can be very uncomfortable especially to children and elderly. Pain management include prescribing NSAIDs or non-steroidal anti-inflammatory drugs like acetaminophen, ibuprofen, etc. although these drugs can be bought over-the-couter, prescription is advised. There are instances where a person is allergic to NSAIDs. There are also medications where combination of codein and acetaminophen is prescribed by the doctors.
This means that the area affected should not be move. Immobilization is important because it aids in the normal healing process of the bone. Over time the bone heals naturally but it needs proper be aligned properly. Certain immobilization techniques include casting or splinting.
However the orthopedics should be careful in this process especially casting because it can lead to certain complications like nerve injury and compartment syndrome. Splinting and casting is common in children and elderly and this can be done as a treatment in buckle fracture.
In buckle fracture, surgery is not necessary because it can be corrected by immobilization techniques. However in severe cases, surgical interventions can be an option by the orthopedic surgeon but this is done when the conservative treatment does not apply to the patient.
There are different surgeries that can be opted such as the closed reduction external fixation (CREF) or the closed reduction internal fixation (ORIF). Post surgery complications are often watched out for like nerve injuries, pulmonary embolism, deep vein thrombosis and others.
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