1.
2.
Management of Wrist Buckle Fractures in the Pediatric Population:
A Survey of Canadian Emergency Physicians
ID#: ____
Buckle fractures of the wrist are a common reason for visits to the Emergency
Department. In many cases, these children present several days after the initial injury with complaints of discomfort and/or mild swelling. Often, they are placed in a cast or a splint for several weeks. In this scenario, questions have been raised by emergency physicians as to the probable outcome, had medical attention not been sought.
Management of wrist buckle fractures has been noted to vary with some children being placed in a cast (with follow-up by orthopedics) while others are placed in a splint for several weeks (with follow-up by their family physician). Length of immobilisation is also variable. The aim of this study is to document the variation(s) in the management of wrist buckle fractures in the pediatric population, among emergency physicians and orthopedic surgeons in Canada.
This survey consists of 11 questions and should take less than five minutes to complete. Your answers will be held in confidence and only aggregate data will be reported. The questions concern you, your experiences and your attitudes toward the management of wrist buckle fractures in children and youth.
For the purposes of this survey, a wrist buckle fracture occurs when the cortex on one side of the bone is compressed while it remains intact on the opposite side. Please answer each question by placing an “X” in the box beside the response that best describes your situation.
In what year did you graduate from medical school? ______
For how long have you practised as a staff physician in emergency medicine?
 < 2 years



2-4 years
5-9 years
> 10 years
3. Many options are available for the treatment of wrist buckle fractures. These are listed below. Please indicate how often you use each treatment modality for the fracture indicated by using the following scale:
1. Never 2. Rarely 3. Sometimes 4. Usually 5.
Distal radius Distal ulna Both*
Always
Cast
Backslab/Splint
Tensor bandage
No treatment
* “Both” refers to the distal radius and distal ulna being fractured on the same wrist.
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Management of Wrist Buckle Fractures in the Pediatric Population:
A Survey of Canadian Emergency Physicians
ID#: ____
4. In general, how long do you believe that a buckle fracture needs to be immobilised?
5.








Not sure
Until pain free
< 1 week
1 week
1-2 weeks
2 weeks
2-3 weeks
3 weeks


Do you suggest that a patient must wear a backslab constantly until followup?
3-4 weeks
> 4 weeks


Not Applicable/Don’t use backslabs
Never




Rarely
Sometimes
Usually
Always
6. Do you suggest that a patient may remove a backslab for bathing?

Not Applicable/Don’t use backslabs


Never
Rarely



Sometimes
Usually
Always
7. Do you suggest that a patient may remove a backslab for other activities?

Not Applicable/Don’t use backslabs


Never
Rarely



Sometimes
Usually
Always
8. Do you suggest that patient may remove a backslab at home after a certain length of immobilisation and leave it off ?


Not Applicable/Don’t use backslabs
Never




Rarely
Sometimes
Usually
Always
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9.
Management of Wrist Buckle Fractures in the Pediatric Population:
A Survey of Canadian Emergency Physicians
ID#: ____
Do you believe that all wrist buckle fractures need to be immobilised?

Not sure → please specify why (may choose more than one answer):
___ unaware of literature suggesting benefits of not immobilising


___ other (please specify): ___________
Yes → please specify why (may choose more than one answer):
___ pain relief
___ risk of refracture/extending fracture
___ parental factors
___ medical/legal concerns
___ other (please specify): ___________
No→ please specify why (may choose more than one answer):
___ Believe inherently stable
___ Low risk of refracture
___ o ther (please specify): ___________
10. Do you believe that a buckle fracture that looks like this x-ray (Figure 1) needs to be immobilised?

Not sure → please specify why (may choose more than one answer):
___ unaware of literature suggesting benefits of not immobilising
___ other (please specify):
___ ensures better healing
___ pain relief
___________

Yes → please specify why (may choose more than one answer):

___ risk of refracture/extending fracture
___ parental factors
___ medical/legal concerns
___ other (please specify): ___________
No→ please specify why (may choose more than one answer):
___ No difference in healing
___ Believe inherently stable
___ Low risk of refracture
___ o ther (please specify): ___________
Figure 1
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Management of Wrist Buckle Fractures in the Pediatric Population:
A Survey of Canadian Emergency Physicians
ID#: ____
11. Do you believe that a buckle fracture that looks like this x-ray (Figure 2) needs to be immobilised?

Not sure→ please specify why (may choose more than one answer):
___ unaware of literature suggesting benefits of
___
___ not immobilising other (please specify): ensures better healing
___ pain relief
___________

Yes → please specify why (may choose more than one answer):
___ risk of refracture/extending fracture
___ parental factors

___ medical/legal concerns
___ other (please specify): ___________
No→ please specify why (may choose more than one answer):
___ No difference in healing
___ Believe inherently stable
___ Low risk of refracture
___ o ther (please specify): ___________
Figure 2
That’s it! Thank you for taking the time to complete this questionnaire.
Please place your completed questionnaire in the envelope that has been provided and return it to Amy Plint in the ED.
If you have any questions concerning the study or wish to share anything with us that we may have neglected to ask, please feel free to do so in the space below. You may also contact the Study Coordinator, Dr.
Amy Plint at the Children’s Hospital of Eastern Ontario, at (613) 737-7600 ext 3237.
Again, thank you very much for your time.
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