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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 children	retrospective clinical trial	number of trials found	2 studies were used	22 patients failed to attend follow up statistical methods not described study doesn't state how the randomisation was performed
			quality of trials found	both studies were deemed to be high quality
			effect of splint as treatment	just as effective as a plaster of Paris cast
			cost effectiveness	useage 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