Related Experiment Video
Updated: Jul 15, 2026
Development of a Novel Internal Fixation Model for Rat Radial Fractures: Fracture Healing Assessment and Dorsal Root Ganglion Isolation
Published on: March 13, 2026
Wrist buckle fractures: a survey of current practice patterns and attitudes toward immobilization
Amy Plint1, Tammy Clifford, Jeff Perry
1Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Insights
Pediatric buckle wrist fractures have varied management. While many physicians immobilize them, a significant portion do not, indicating uncertainty in optimal treatment strategies for these common childhood injuries.
Area of Science:
- Pediatric Orthopedics
- Emergency Medicine
- Pediatric Trauma
Background:
- Buckle fractures are the most common wrist fractures in children.
- Limited literature exists on optimal management strategies for pediatric buckle fractures.
Purpose of the Study:
- To examine the current management practices for pediatric wrist buckle fractures.
- To assess the attitudes of pediatric emergency department (ED) physicians and orthopedic surgeons regarding immobilization.
Main Methods:
- A standardized survey was distributed to pediatric orthopedic surgeons and ED physicians at 8 Canadian children's hospitals.
- Physician responses regarding fracture management and immobilization preferences were collected and analyzed.
Main Results:
- 87% of physicians responded, with varied opinions on immobilization (64% believe it's always necessary).
- Orthopedic surgeons showed preference for below-elbow casts, while ED physicians commonly used casts or backslabs.
- Significant variation exists in recommended immobilization duration, with most suggesting 2-4 weeks.
Conclusions:
- There is considerable physician disagreement on the necessity of immobilizing pediatric buckle wrist fractures.
- Substantial variability in immobilization type and duration suggests an unclear optimal management strategy.
- Future prospective studies are needed to determine the best approach for managing these fractures.
Objectives:
Buckle fractures are the most common wrist fractures in children, yet there is little literature regarding their management. This study examined the management of these fractures and attitudes toward their immobilization by pediatric emergency department (ED) physicians and pediatric orthopedic surgeons.
Methods:
A standardized survey was mailed to all pediatric orthopedic surgeons and pediatric ED physicians at 8 Canadian children's hospitals.
Results:
Eighty-seven percent of physicians responded, including 33 of 39 pediatric orthopedic surgeons and 84 of 96 pediatric ED physicians. Sixty-four percent of respondents believe that wrist buckle fractures always need to be immobilized; pain control was most frequently cited for this belief. Physicians who did not believe that all buckle fractures need to be immobilized indicated that these fractures are inherently stable and have a low risk of refracture. Forty-eight percent of the orthopedic surgeons prefer below-elbow casts, 30% prefer a combination (splint and cast) and 12% prefer backslabs. Sixty percent of ED physicians "usually or always" use casts and 31% "usually or always" use backslabs. Although there was variation among the orthopedic surgeons regarding the recommended length of immobilization, most (70%) recommended 2 to 4 weeks, although some (12%) treated only until pain free. ED physicians showed greater diversity regarding length of immobilization.
Conclusions:
Although many physicians believe that wrist buckle fractures need to be immobilized, a significant number do not. There is substantial variability in the type and length of immobilization used. This variability suggests that the optimal management strategy for wrist buckle fractures is unclear and should be determined in future prospective studies.
More Related Videos
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
07:35Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
