Recommended Splint for Radial Buckle Fracture
A removable splint is the appropriate treatment for a radial buckle (torus) fracture of the distal radius, worn for 3 weeks without need for routine follow-up imaging or clinic visits. 1
Type of Immobilization
Use a removable wrist splint rather than a circumferential cast for buckle fractures, as recommended by the American Academy of Orthopaedic Surgeons for minimally displaced distal radius fractures 1
Removable splints provide superior patient satisfaction, convenience, and preference compared to casting, with no difference in healing outcomes 2, 3
Buckle fractures are inherently stable compression fractures without cortical disruption, making rigid casting unnecessary 4, 5
Duration of Immobilization
The splint can be supplied directly in the emergency department and does not require specialized orthopedic application 5
Follow-Up Requirements
Radiographic follow-up at approximately 3 weeks is recommended to confirm adequate healing, though current evidence suggests this may not be necessary if patients receive adequate information at diagnosis 1, 5
No routine fracture clinic follow-up is required for uncomplicated buckle fractures once proper patient education is provided 5
Active Motion During Treatment
Initiate active finger motion exercises immediately following diagnosis to prevent stiffness, which is one of the most functionally disabling complications 1
Finger motion does not adversely affect adequately stabilized distal radius fractures and does not compromise healing 1
Early wrist motion is not routinely necessary following stable fracture immobilization 1
When Alternative Treatment Is Needed
If displacement exceeds 3mm, dorsal tilt exceeds 10°, or intra-articular involvement is present, surgical management may be indicated rather than simple splinting 1
For displaced fractures, rigid immobilization with casting is preferred over removable splints 1
Common Pitfalls to Avoid
Do not over-treat stable buckle fractures with circumferential casts, as this increases complications without improving outcomes 2, 3
Monitor for complications such as skin irritation or muscle atrophy, which occur in approximately 14.7% of immobilization cases 1
Ensure proper patient/parent education about the stability of buckle fractures to prevent unnecessary anxiety and healthcare utilization 5
Clinical Advantages of Removable Splints
Children treated with removable splints demonstrate better physical functioning at 14 days post-injury compared to those in casts 3
Splinted patients have significantly less difficulty with bathing and daily activities throughout the treatment period 3
Pain levels are equivalent between splinting and casting, with no increased risk of refracture with splint use 2, 3