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Valve, no valve casts yield similar clinical outcomes for pediatric forearm fractures
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Results showed pediatric patients with forearm fractures had no differences in cast-associated complications and fracture stability when treated with no valve, univalve or bivalve casts after closed reduction.
Mark C. Lee, MD, and colleagues randomly assigned 60 pediatric patients with closed shaft or distal third radius and ulnar fractures that underwent closed reduction to receive a long-arm fiberglass cast with either no valve, univalve or bivalve. Researchers followed patients to 6 weeks after reduction or surgical treatment if required, and recorded the frequency of neurovascular injury, cast saw injury, unplanned office visits, cast modifications, the need for operative intervention and pain levels.
Results showed no significant differences in pain level between the three groups. Researchers noted no incidents of compartment syndrome or neurovascular injury, and no cast saw-related abrasions or thermal injuries. The three groups also had no significant differences in frequency of cast modification for discomfort or paresthesia. Patients had no significant difference in the rate of wedging, researchers found, as well as no significant difference regarding subsequent need for surgical stabilization.
“Low-energy pediatric forearm fractures do not require cast splitting after acute closed reduction and long-arm cast application,” Lee told Healio.com/Orthopedics. “Cast splitting does not change clinical outcome, inclusive of pain control and need for repeat reduction.” – by Casey Tingle
Disclosure: The authors report no relevant financial disclosures.
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