Distal forearm fractures in children; cast level effectiveness

Abstract EN

Objective: To determine whether below-the-elbow casts are as effective as above-the-elbow casts in immobilizing displaced fractures of the distal third of the forearm in children.

Patients and methods: Fifty-two patients with displaced distal forearm fractures from June 2005 to January 2007 were enrolled in this study.

Their age range (4-12) years.

The criteria for reduction and re-manipulation were set a priori. Results: The cast groups did not differ clinically with respect to the initial fracture angulations, post-reduction fracture angulations, and fracture angulations at the time of cast removal.

Eleven (39%) of the twenty eight children in the above the elbow cast group met the criteria for re-manipulation compared with seven (29%) of the twenty four children in the below-the-elbow cast group.

While this reduction of 10% did not reach significance (p = 0.27).

Fractures treated in below-the-elbow casts met the criteria for re-manipulation less frequently than did those treated in above-the-elbow casts.

When the cast was initially removed, the range of elbow motion was significantly less in the group treated with a long arm cast, but there was a minimal difference in the final range of motion between the two cast treatment groups. Conclusions: The effectiveness of a below-the-elbow casts as the same as the above-the-elbow casts to treat fractures of the distal third of the forearm in children.