Treating buckle fractures in children with a soft cast and home removal: a quality improvement initiative
evidence and practice    

Treating buckle fractures in children with a soft cast and home removal: a quality improvement initiative

Kevin Phillips Advanced Nurse Practitioner, Emergency Department, University Hospital Waterford, Waterford, Ireland
Bernadette Breen Advanced Nurse Practitioner, Emergency Department, University Hospital Waterford, Waterford, Ireland

Why you should read this article:
  • To understand the treatment options available for children with buckle fractures

  • To learn how soft casting could be more effective in managing buckle fractures than the traditional method of using a rigid cast

  • To explore ways in which you could improve the management of buckle fractures in your area of practice

Buckle fractures of the distal radius are unique to children and a frequent presentation in the emergency department (ED). In University Hospital Waterford, Ireland, the treatment of buckle fractures followed the traditional method involving a rigid cast and a follow-up hospital appointment. However, the latest literature indicates that buckle fractures are stable and heal without complication, so a minimalist approach to treatment is recommended. Therefore, the advanced nurse practitioners in the ED introduced a change in protocol at the hospital. This involved the use of a soft cast for removal at home, with verbal and written discharge information and no follow-up appointment.

An audit was conducted to ensure that this new protocol was safe and effective, and the time and distance saved by patients through avoiding a return hospital visit was estimated. Treatment in a soft cast with verbal and written discharge information revealed a successful outcome for all 88 patients included in the audit. Avoiding return hospital visits resulted in significant travel time and distance savings for patients and families.

Emergency Nurse. doi: 10.7748/en.2020.e2043

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software

Correspondence

kevin.phillips@hse.ie

Conflict of interest

None declared

Phillips K, Breen B (2020) Treating buckle fractures in children with a soft cast and home removal: a quality improvement initiative. Emergency Nurse. doi: 10.7748/en.2020.e2043

Published online: 28 July 2020

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