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WRIST: METAPHYSEAL FRACTURES

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BUCKLE/ Torus FRACTURE

  • Subtle unilateral or bilateral cortical bulge on X-ray

  • Both cortices intact

MANAGEMENT​

  • Below Elbow backslab or removable Futura Splint

  • Fracture clinic

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MANAGEMENT

Analgesia

Acceptable angulation dependent on age.

  • <5 years 20 degrees

  • 5-10 years 15 degrees

  • >10 years 20 degrees

  • Bayonet apposition (bone fragments lie side by side instead of end to end) acceptable under the age of 6.

  • Below elbow back slab - 3 point moulding. 

    • If distal fragment is dorsally angulated- slight flexion

    • If distal fragment has volar angulation -slight extension.

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Refer to ORTHO if:

  • Open fracture

  • Reduction not possible

  • Neurovascular injury

  • Associated fracture in same limb.

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COMPLETE METAPHYSEAL FRACTURES

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