A systematic review of alternative splinting versus complete plaster casts for the management of childhood buckle fractures of the wrist.

Hill, C. E. et al. Journal of pediatric orthopedics. Part B, vol. 25, no. 2, p. 183-190, 1473-5865 (March 2016)

N0017004 Fracture, distal radius and ulna
Image source: Wellcome Images

Image shows fracture, distal radius and ulna

Abstract:  Paediatric wrist-buckle fractures are common distal radius fractures with inherent stability. Traditional management with complete plaster-cast immobilization necessitates follow-up visits, time off school/work and hospital treatment costs. Treatment with alternative splinting, negating the need for follow-up visits and saving time and money, has been proposed. However, concerns with regard to complications, primarily pain, have been raised; hence, the topic remains controversial.

A systematic review was performed with eight randomized-controlled trials analysed. Alternative splinting was superior to casting in terms of function, cost and convenience, but with no significantly worse pain or fracture complication level. The evidence endorses the use alternative splinting over casting in paediatric wrist-buckle fractures.

Read the abstract here



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