Simple dorsal buckle fractures must have ALL of the following features: Simple dorsal buckle fracture of the distal radius and ulna with minimal dorsal angulation X-Ray changes may be subtle with mild cortical bulging on the AP view and angulation on the lateral view may be evident.Buckle (or torus) fractures are most commonly seen in the distal radial metaphysis and are a result of compressive forces from an axial load on softer bones in children.Be aware the scaphoid only starts to ossify at 5 years of age.įor general assessment and management, see Fractures - Overview. A scaphoid X-ray series should have four views.A wrist X-ray should have PA and lateral views and include the proximal half of the metacarpals and distal third of the radius and ulna.In children over 10 years of age, look for clinical signs of a scaphoid fracture: anatomical snuffbox tenderness, pain on axial compression of thumb, and pain on supination against resistance.Clinical deformity is usually evident in displaced fractures (most commonly dorsal displacement and angulation).Limitation in supination may be a sign of minor buckle fractures.There is usually localised tenderness and swelling with decreased range of movement.The most common mechanism of injury is a fall onto an outstretched hand. R ead the full PCH Emergency Department disclaimer. Clinicians should also consider the local skill level available and their local area policies before following any guideline. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinical common-sense should be applied at all times. They are not strict protocols, and they do not replace the judgement of a senior clinician. These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. Note: Some images also show associated injuries and before and after results.Fractures - Distal forearm or wrist Disclaimer The images below show different fractures. Whether you will need surgery or just casting depends on the severity of the ankle injury. Identifying if fracture ankle surgery is necessary for medial malleolus ankle fractures is usually straightforward. Medial malleolus fractures are relatively uncommon. You step wrong and twist your foot inward or outward to cause the break. A majority of ankle fractures are the result of rotational forces. The break may occur by itself but it normally accompanies injuries to the outside of the ankle or a fibula fracture of the smaller of the two lower leg bones. Medial malleolar fractures involve the articular surface of the ankle joint, which is where the bones meet in the joint. It bears 90% of the weight-bearing load, so this is a common fracture. You can feel this area as the bump on the inner side of your ankle joint. The medial malleolus is an anatomical region of the tibia bone, which is the larger of the two lower leg bones. Medial malleolus fractures are classified by the actual orientation of the fracture line. When you break the inner bone of your ankle, it is called a medial malleolus ankle fracture.
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