From the Research
For a 3-year-old with a minimally deformed ulnar buckle fracture, immobilization in a cast typically lasts 3-4 weeks. This recommendation is based on the most recent and highest quality study available, which emphasizes the importance of balancing proper bone healing with minimizing complications of prolonged immobilization in young children 1. The cast should be a short-arm cast extending from below the elbow to the hand, leaving the fingers and thumb free for movement.
Key considerations for managing this type of fracture include:
- The child's age and the type of fracture, as children's bones heal more quickly than adults', and buckle fractures are stable injuries with good healing potential.
- The use of a short-arm cast, which is sufficient for immobilization and allows for some movement of the fingers and thumb.
- Follow-up with an orthopedic provider, typically with an X-ray at 3 weeks to confirm adequate healing before cast removal, is crucial for ensuring proper healing and minimizing potential complications.
After cast removal, the child can gradually return to normal activities, though parents should limit rough play for an additional 1-2 weeks. No specific medications are typically needed beyond over-the-counter pain relievers like acetaminophen (10-15 mg/kg every 4-6 hours as needed) for the first few days. This approach is supported by recent studies that highlight the effectiveness of short-term immobilization for buckle fractures in children, while also considering the potential for new treatment modalities such as removable elastic bandages 1.