A buckle fracture is a common bone injury, especially among young children, occurring when a bone is compressed but does not break completely through its entire width. This incomplete fracture is generally considered minor compared to a full break and is frequently seen in pediatric emergency rooms following a simple fall. It often results from a sudden impact, such as catching oneself during a tumble or fall. This pattern is a direct result of the unique composition of a growing skeletal structure.
What Exactly is a Buckle Fracture?
A buckle fracture is also known by the medical term torus fracture, which refers to a bulging or protuberance in the bone structure. It is fundamentally a compression fracture, meaning the force that causes the injury pushes the bone together along its long axis rather than snapping it across. When a long bone, like those in the forearm, absorbs this longitudinal force, the bone substance crunches and bulges outward at the site of impact.
To visualize this process, imagine a hollow aluminum soda can crushed from the top; the side walls wrinkle and deform but remain connected. Similarly, the dense outer layer of the bone, called the cortex, is compressed and buckles on one side. The opposite side remains intact, classifying the injury as incomplete. Because the pieces are not displaced, the bone is considered stable.
Recognizing Symptoms and Why It Happens Most Often in Children
Parents often recognize a buckle fracture by the symptoms appearing shortly after a fall. The child typically experiences mild to moderate pain, which is less intense than the severe pain associated with a complete break. Swelling and tenderness are usually localized around the injured area, most frequently the wrist, which is the site of the distal radius bone. The child may show reluctance to use the affected limb but often retains a limited ability to move the joint.
This specific injury occurs predominantly in children under the age of twelve because of the unique characteristics of their bones. Pediatric bones are softer, more porous, and contain a higher proportion of cartilage compared to adult bones. This increased flexibility and elasticity allows the bone to absorb compressive energy by bending and buckling instead of fracturing cleanly across its diameter. The most common cause is a Fall Onto an Outstretched Hand (FOOSH), where the force travels up the arm and compresses the softer bone near the wrist.
Diagnosis, Treatment, and Expected Recovery
The first step in confirming a suspected buckle fracture is a medical examination followed by diagnostic imaging. A healthcare provider will order an X-ray to visualize the bone and confirm the presence of the characteristic bulge or wrinkle in the bone’s cortex. This imaging is also necessary to rule out a more serious complete fracture or an injury involving the growth plate, which is the soft, developing tissue near the ends of a child’s bones.
Because the bone remains stable and the pieces are not displaced, a buckle fracture rarely requires invasive procedures like surgical fixation or bone repositioning. Treatment almost always involves simple immobilization to protect the bone while it heals naturally. This is achieved using a removable wrist brace or a short, non-circumferential cast, often called a backslab.
The immobilization device is typically worn for three to four weeks, providing support and comfort as the bone mends. Healing is rapid and complete, with children making a full recovery without long-term complications. Following the removal of the brace or splint, physical therapy is seldom required, and full return to all normal activities, including sports, is permitted once pain-free movement is restored.