Most mild wrist fractures do well. In younger children these may commonly involve the growth plate of the radius and/or ulna (the two forearm bones). Milder growth plate fractures (sometimes referred to as "Salter" or "physis" fractures) heal relatively quickly requiring casting usually between two to four weeks with sometimes bracing worn for a few weeks after. When properly treated, these fractures heal without any long term problems.
Another type of pediatric fracture is a buckle (sometimes called a "torus") fracture. These fractures are the result of an injury to a bone that is still softer and less calcified than adult bones. You can imagine this injury as if you tried to force two ends of a piece of paper together causing a crinkling, or buckling, of the paper.
A variation of this is a "greenstick" fracture. This, as the name implies, is a fracture of a young bone that is similar to the bending of a young (still green on the inside) tree's limb. Here the bone does not break into two pieces, but it bends remaining intact on the inside and fractures on the outside of the curve.
The scaphoid is a small bone located in the wrist. A scaphoid fracture may occur by falling back on an extended wrist. Basketball players commonly present with this complaint. This injury causes pain in the wrist near the base of the thumb. There is stiffness in addition to swelling and tenderness in the anatomic snuffbox. If a scaphoid fracture is suspected, at least three radiographic views including a special scaphoid view should be obtained. Scaphoid fractures are often not visible on initial x-rays.
Do to the poor blood supply of the scaphoid, an injured wrist with a history and an exam that suggest a scaphoid fracture should be placed into a thumb spica cast, even if the x-rays are normal. After two weeks the cast is removed and the wrist is examined. If the scaphoid remains tender, casting is continued until diagnosis is confirmed with possible MRI or CT scan performed at four weeks. A definite fracture is treated with casting for at least six weeks. Some fractures may not heal correctly and require surgery.
When properly treated, these fractures typically heal without any long term problems.Request An Appointment