Best position of immobilisation in a greenstick fracture of the distal radius
- Report By: Pranam Patel - medical student
- Institution: Manchester Royal Infirmary
- Date Submitted: 14th July 2005
- Last Modified: 14th July 2005
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Status:
Blue (submitted but not checked)
Three Part Question
in [a child aged 3-12] with [a greenstick fracture of the distal radius] should [the forearm be immobilised in the pronated, neutral or supinated position]Clinical Scenario
an eight year old child presents to the emergency department with a suspected wrist fracture. radiology confirms a greenstick fracture of the distal radius. treatment is with the application of a plaster of Paris cast, but in which position should the forearm be immobilised (pronated, neutral or supinated)Search Strategy
Medline 1966- June 2005CINAHL 1982- June 2005
The cochrane library, issue 2, 2005
Search Outcome
1 citation which was a high quality randomised control trialRelevant Paper(s)
| Author, date and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Gupta RP Feb 1990 Safat | 60 children, 20 randomly allocated to each group | prospective randomised control trial | re-displacement after immobilisation | angular displacement greatest in pronation group and least in the supination group |
Comment(s)
fracure of the distal radius is a common injury in children. treatment is with the application of a plaster of Paris cast. this review has found that angular displacement after the application of a cast occurs less often when the forearm is immobilised in the supinated position.Clinical Bottom Line
forearm should be immobilsed in the supinated positionReferences
- Gupta RP Dorsally angulated solitary metaphyseal greenstick fractures in the distal radius: results after immobilisation in pronated, neutral and supinated position