There is no established 'standard' treatment for buckle fractures but methods vary from soft bandages to removable splints to stricter immobilization such as casting for 2-4 weeks, with regular follow-ups until fracture union, though there is growing evidence that plaster casts are unnecessary. The need for follow-up is similarly uncertain, with around 50% of hospitals in the UK routinely planning no follow-up after this diagnosis in the ED (Emergency Department). A national guideline from the UK National Institute for Health and Care Excellence (NICE) identified that all treatments appeared safe and recommended either a removable splint or a bandage, without the need for a follow-up. In fact, the NICE guideline questioned whether any treatment was necessary at all for these fractures. Studies have shown that, with removable methods at home, without the necessity of a follow-up appointment, parental satisfaction of nearly 100% is achieved. Given the ongoing variation in treatment, in terms of type of immobilisation, and necessity for follow-up, the National Institute for Health Research in the UK have funded a randomised controlled trial, to definitively address this uncertainty. The trial, led by the University of Oxford, is called the FORCE study and is a large pragmatic trial underway at 23 ED's, throughout the UK.
Torus fracture
Jefferson fracture
Bosworth fracture
Rolando fracture
Smith fracture
Jones fracture
March fracture
Holdsworth fracture