Treatment of Nondisplaced Buckle Fracture Deformity of the Distal Radial Metaphysis

Treatment Approach

The American Academy of Orthopaedic Surgeons (AAOS) recommends removable splints as an appropriate option for treating minimally displaced distal radius fractures 1, 2

Radiographic follow-up is recommended at approximately 3 weeks and at the time of immobilization removal to confirm adequate healing 1

If there is any significant displacement (>3mm), dorsal tilt (>10°), or intra-articular involvement, surgical management may be indicated instead of conservative treatment 3, 4
For displaced fractures, rigid immobilization (casting) is preferred over removable splints 1, 4
Monitor for potential complications such as skin irritation or muscle atrophy, which occur in approximately 14.7% of immobilization cases 4

Active finger motion exercises should be performed following diagnosis to prevent stiffness, which is one of the most functionally disabling adverse effects of distal radius fractures, as recommended by the American Academy of Orthopaedic Surgeons 5
Finger motion does not adversely affect adequately stabilized distal radius fractures in terms of reduction or healing, according to the American Academy of Orthopaedic Surgeons 5
Early wrist motion is not routinely necessary following stable fracture fixation, as stated by the American Academy of Orthopaedic Surgeons 6

The American Academy of Orthopaedic Surgeons suggests that if post-reduction imaging shows radial shortening >3mm, dorsal tilt >10°, or intra-articular displacement, surgical fixation is recommended rather than conservative management 7
Persistent nerve dysfunction after reduction may require nerve decompression, though evidence is inconclusive 7

The American Academy of Orthopaedic Surgeons suggests vitamin C supplementation for prevention of disproportionate pain with moderate recommendation strength 8
Ultrasound and/or ice are options for adjuvant treatment, though evidence is weak 8