Overview

A buckle fracture is sometimes referred to as an “incomplete fracture,” because the break is only on one side of the long bone of the arm or leg. This injury is also called a “torus fracture,” and is most common in children whose bones are softer and less brittle than adults.

If your child has suffered a buckle fracture, it will be important to make sure the bone stays protected during the next several weeks.

Symptoms

A buckle fracture causes a lot of acute pain. The pain may subside if the injured limb is protected. By definition, a buckle fracture is a stable fracture and stable fractures are less painful than unstable fractures.

If the fracture is serious enough, you may be able to see the arm or leg bend in an abnormal way. Any kind of sudden deformity in the leg or arm is a likely sign that a buckle fracture has occurred. However, just because there is no deformity does not rule out a fracture.

The site of the break will also swell and be tender to the touch. As a general rule, if a child has been injured and the injured area is tender to the touch, they may have a fracture.

If the buckle fracture is in the forearm, it may be difficult for the injured person to turn his or her wrist or elbow. If the broken bone is in the leg, it will be very painful or impossible to put weight on it. Putting weight on the bone can make the break and symptoms worse.

Causes

A broken arm or leg can happen as a result of a fall or from a serious impact or collision. It happens when the injury is severe enough to crack the bone, but not so bad that the break extends all the way through the bone. Because children’s bones are softer and more pliable, the fall or blow can cause the bone to buckle without breaking.

Playing sports or engaging in any physical activity, such as bicycle riding and tree climbing, can result in an injury. Kids are also at risk for fractures if they are in an environment where child abuse is ongoing.

In adults, osteoporosis can increase risk for buckle fractures. Balance problems, general weakness, and poor nutrition may also increase the risk for buckle fractures.

Diagnosis

There are several different types of fractures, some of which have more obvious signs than others. An open fracture, for example, has a broken bone that sticks out through the skin.

With a buckle fracture, the skin isn’t broken, but you may notice that the arm or leg is bent in an abnormal way. The bone will bend out on the opposite side from the break. This is different from a greenstick fracture, which also causes the bone to bend near the site of the break. With a greenstick fracture, the bone bends outward on the side of the break.

The main way doctors diagnose the type of fracture is with an x-ray. A few x-rays may be taken in order to view the affected bone from more than one angle, but also to see if any nearby joints were injured.

An x-ray can also reveal the exact location of the break, the size of the fracture, and whether any growth plates at the ends of the bones were affected. Your doctor will also check for feeling in the hands and feet to help determine if there was any nerve damage.

Treatment

Treatment of any broken bone should begin as soon as possible, regardless of age. Children’s bones start to heal more quickly than the bones of adults, so any suspected fracture in a child should be evaluated immediately.

A broken arm or leg should be set and stabilized by a cast or by removable splints. A cast will prevent the bone from moving or being further injured. A removable splint can also keep the bone immobilized. The advantage of a removable splint is that it can be taken off for bathing.

If the break is bad enough so that the bones don’t line up properly for healing, surgery may be needed to set the bones in place. Surgery may add a few more weeks to the recovery time.

Recovery

You can expect to wear a cast or splint for at least three weeks, though if surgery was required, a few more weeks of recovery may be necessary. You may have to stay off a leg or put little pressure on it if the break was in your leg bone. A walking boot may be used to allow for some mobility while still protecting the leg.

After a few weeks of being immobile in a cast or splint, you may be able to resume some activities. Your doctor may recommend avoiding high-risk activities, such as contact sports, for several more weeks.

Complications

At some point during recovery, you will need to have a follow-up appointment with your doctor. They may take another x-ray to see how the bone is healing. If the bone isn’t healing properly, surgery may be scheduled to set the bone and put it back in a cast or splint.

You should also see the doctor if your pain worsens. If a cast gets very wet or becomes cracked or damaged, you should also see your doctor. A new cast can be made to replace the damaged one.

Outlook

A buckle fracture that is treated properly should heal fine and without any long-term problems. If you limit your activities while the bone heals, the outlook is usually positive.

Home care

If your child has a buckle fracture, you can help them get through the healing and treatment phase. Follow their doctor’s advice and remind your child that the better they are about protecting their injury, the sooner they can be active and start playing again.

  • In the first couple of days after a fracture, it’s important to keep the arm or leg elevated.
  • You should also ice the injured area every hour or two in the first couple of days. Ice can be placed on top of the splint or cast, but you want to avoid getting the cast or splint wet. Cover the cast or splint in plastic before applying ice to reduce the spread of moisture.
  • Avoid putting anything, including creams or products, inside the cast or splint to treat itchiness.
  • Call your doctor’s office if you have any questions about treatment. A nurse may be able to answer your question quickly.