Of note, on the posteroanterior view, the green arrows show the fracture across the distal radius and a subtle buckle fracture of distal ulna.
Explore This IssueACEP Now: Vol 36 – No 10 – October 2017
Case 2: Simple buckle fracture of distal radius, stable.
Patient 2: 10-year-old male
Red arrow identifies the 1st metacarpal (thumb, volar side). Blue arrow shows the subtle buckle.
The fracture line does not extend to the volar cortex; there is no angulation.
This is a simple dorsal buckle fracture of the distal radius, stable, and well-managed in a removable splint for comfort and protection.
Case 4: Volar-based fracture of the distal radius with mild angulation that requires molding in extension and close follow-up.
Patient 4: 6-year-old female
Red arrow identifies the 1st metacarpal (thumb, volar side)—a little confusing because it overlaps with the 5th metacarpal. Blue arrow shows the buckle, but it is on the volar side.
The solid black line is along the axis of the proximal fragment of the radius and extended beyond the fracture, the dashed black line is along the axis of the distal fragment, and the lines are not parallel. There is mild angulation of the distal fragment volarly.
This case is also subtle, and if we don’t recognize the thumb/volar side, this will be incorrectly molded in flexion, which will increase the angulation, not help to correct it. So again, this is not a simple buckle fracture of the distal radius. However, this is unstable with a tendency to shift volarly and needs to be molded in extension.
Of note, on the posteroanterior view, the green arrow also shows the fracture of the distal radius.
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