Ann Robinson’s research reviews—22 September 2022

Buckling under pressureChildren break their wrists with alarming ease and frequency. The commonest type of fracture in children is a torus (from the Latin for protuberance) or buckle fracture, in which the soft, compressible radius and ulna bend or crack under the impact of a fall but don’t break into the cortex. Approaches to treatment differ, and this large multicentre UK trial found that treatment with a bandage and immediate discharge was as safe and effective as rigid immobilisation (using a wrist splint in 97% of cases and plaster cast in 3%) and routine follow-up regardless of the age of the child. No one needed surgery or fracture manipulation. The bandage group used more analgesia in the first 24 hours, but, overall, the rate of complications, pain, return to school, and self reported function scores didn’t differ between the two groups at six weeks after the injury. These results reinforce…
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