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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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Bones of the Upper Limb: Radius01:09

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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
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Volar Distal Radius Buckle Fractures: Is Bracing and Home Management Safe?

Meghana Nandigam1, Margarita Chmil, Benjamin Patrick Thompson

  • 1From the Radiology.

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Summary

Removable brace treatment is safe for volar distal radius buckle fractures in children. Shared decision-making with caregivers can influence treatment choices for these common pediatric fractures.

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Area of Science:

  • Pediatric Orthopedics
  • Pediatric Traumatology
  • Pediatric Fracture Management

Background:

  • Distal radius buckle fractures are common pediatric injuries, typically involving the dorsal cortex.
  • Current standard treatment involves removable braces and home management.

Purpose of the Study:

  • To evaluate the safety and efficacy of removable brace and home management for volar distal radius buckle fractures.
  • To compare outcomes of volar versus dorsal distal radius buckle fractures.

Main Methods:

  • Retrospective review of pediatric distal radius buckle fractures (ages 3-16) from April 2019 to May 2022.
  • Fractures classified as dorsal or volar based on strict diagnostic criteria.
  • Analysis of demographic data, injury mechanisms, treatment, and complications.

Main Results:

  • 333 fractures identified: 254 dorsal (76%) and 79 volar (24%).
  • Volar fractures occurred in older children (mean 9.3 years) and more frequently in girls.
  • High rates of initial removable brace treatment (96%) for both fracture types, with similar continuation rates (82% dorsal, 89% volar).
  • Low rate of conversion to cast (11% volar vs. 18% dorsal), often influenced by caregiver preference.
  • Only one volar fracture patient required an additional visit for persistent pain.

Conclusions:

  • Removable brace and home management are safe treatment options for volar distal radius buckle fractures when diagnosed using strict criteria.
  • Shared decision-making with caregivers is important and can influence treatment selection.
  • This approach supports conservative management for pediatric volar buckle fractures.