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Is a cast as useful as a splint in the treatment of a distal radius fracture in a child

Three Part Question

in [a child aged 3-12] is [a splint as useful as a cast] to [treat a distal radius fracture]

Clinical Scenario

An eight year old child presents to the emergency department with signs and symptoms of a fractured wrist. radiology confirms a fracture of the distal radius.

Search Strategy

Medline 1966-June 2005
CINAHL 1982-June 2005
The Cochrane library, issue 2, 2005

Search Outcome

23 citations of which 1 high quality retrospective clinical trial was found

Relevant Paper(s)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses
Davidson JS et al
Nov 2001
UK
randomised 201 childrenretrospective clinical trialnumber of trials found2 studies were used22 patients failed to attend follow up statistical methods not described study doesn't state how the randomisation was performed
quality of trials foundboth studies were deemed to be high quality
effect of splint as treatmentjust as effective as a plaster of Paris cast
cost effectivenessuseage of a splint is more cost effective than a plaster of Paris cast

Comment(s)

immobilisation of the forearm is the accepted method of treatment of a torus fracture of the distal humerus. the use of a splint has been found to be just as effective as the use of a cast, but the use of a splint is far more cost effective. the use of a splint leads to a saving of 53 per patient, as it is self-removable and therefore the patients need not attend follow up clinic

Clinical Bottom Line

the use of a splint is as effective as a plaster of Paris cast

References

  1. Davidson JS simple treatment for torus fractures of the distal radius