• Rationale and Comments

    Distal radius buckle fractures are one of the most common wrist fractures in children. These fractures are inherently stable and have an excellent prognosis. Radius buckle fractures can be safely treated with a Velcro removable wrist splint for three to four weeks, as long as the following conditions are met: 1) cortex is intact, 2) there are no fracture lines extending to the physis on any view, 3) there is no angulation or displacement of the fracture, 4) there are two or three inflection points seen in the cortex on either view that best represents the fracture, and 5) the parent can do a symptom check with instructions. Treating in a cast and repeating x-rays increases health care costs and radiation exposure for the patient. Parent satisfaction is also increased when these fractures are treated with a brace.

    Sponsoring Organizations

    • American Medical Society for Sports Medicine


    • Expert consensus


    • Orthopedic
    • Pediatric


    • Little KJ, Godfrey J, Cornwall R, et al. Increasing brace treatment for pediatric distal radius buckle fractures: using quality improvement methodology to implement evidence-based medicine. J Pediatr Orthop. 2019;39(8):e586-e591.
    • Kuba MHM, Izuka BH. One brace: one visit: treatment of pediatric distal radius buckle fractures with a removable wrist brace and no follow-up visit. J Pediatr Orthop. 2018;38(6):e338-e342.
    • West S, Andrews J, Bebbington A, et al. Buckle fractures of the distal radius are safely treated in a soft bandage: a randomized prospective trial of bandage versus plaster cast. J Pediatr Orthop. 2005;25(3):322-325.