Current management of torus fractures of the distal radius

The use of a forearm cast for paediatric buckle fractures of the distal radius is widespread practice. These fractures do not displace and follow-up in fracture clinic is only for cast removal. This may mean missed school for the child, or work for parents. Modern materials allow a robust lightweight backslab to be used for protection of these stable, though painful, injuries. Unlike a plaster of Paris backslab, Prelude (Smith and Nephew) is removed by unwrapping the outer bandage. Parents can do this at home. We prospectively studied 41 consecutive children aged 12 years or less with buckle fractures of the distal radius, presenting to our fracture clinic. After the diagnosis of isolated buckle fracture was confirmed, a Prelude backslab was applied. Parents were given a full explanation and written instructions, which were also sent to the GP. Telephone follow-up was carried out at 3-4 weeks. Forty out of forty-one parents expressed satisfaction with both the treatment and the instructions. The parents of one patient misunderstood the instructions, represented to fracture clinic and were dissatisfied for this reason.With modern casting materials and adequate instructions in fracture clinic, further follow-up of patients with buckle fractures is unnecessary. Resource savings can be made in this way with no compromise to patient care and increased patient/parent satisfaction.