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Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures

Per-Henrik Randsborg1, Einar A Sivertsen

  • 1Department of Orthopedic Surgery, Akershus University Hospital, Norway. pran@ahus.no

Acta Orthopaedica
|November 18, 2009
PubMed

Insights

Buckle fractures of the distal radius in children are stable and do not require follow-up. Greenstick fractures, however, remain unstable and may displace after two weeks, necessitating careful monitoring.

Area of Science:

  • Pediatric Orthopedics
  • Radiology
  • Traumatology

Background:

  • Follow-up visits for pediatric wrist fractures often lack therapeutic impact.
  • Assessing complications and management changes is crucial for effective treatment.

Purpose of the Study:

  • To evaluate the necessity of follow-up visits for pediatric distal radius fractures.
  • To determine the rate of complications and changes in management based on fracture type.
  • To assess the stability of greenstick and buckle fractures through radiographic comparison of lateral angulation.

Main Methods:

  • Retrospective review of 305 distal radius fractures in patients under 16 years old.
  • Documentation of all observed complications during follow-up.
  • Radiographic assessment of fracture type and lateral angulation from initial films.

Main Results:

  • Only one follow-up visit (out of 311) resulted in an active intervention.
  • Greenstick fractures exhibited a higher complication rate compared to buckle fractures.
  • Buckle fractures showed minimal change in lateral angulation, while greenstick fractures displaced an average of 5 degrees, continuing after two weeks. Complete fractures displaced 9 degrees.

Conclusions:

  • Buckle fractures are stable and do not necessitate follow-up.
  • Greenstick fractures are unstable and prone to displacement beyond two weeks.
  • A precise initial classification can identify pediatric distal radius fractures requiring follow-up, optimizing resource allocation.
Abstract

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