None listed
Conditions
Brief summary
The current standard of treatment following closed reduction of pediatric distal third radius fractures involves the placement of a well molded cast to maintain reduction. Casts provide rigid, circumferential immobilization. Because of the fixed diameter of the cast, there is minimal ability for the cast to accomodate fluctuations in soft tissue swelling that occurs after an acute injury. In the acute phase, casts can cause compression of neurovascular structures if wrapped too tightly. As the swelling resolves, the cast loses its ability to maintain fracture reduction due to a loss of contact between the cast material and the extremity. Studies have shown up to a 35% re-reduction rate in pediatric distal third radius fractures after manipulation and casting. This study is designed to investigate if the application of a sugar tong splint with an elastic bandage immediately following closed reduction will lead to a decrease in the rereduction rate. A sugar tong splint with an elastic bandage is capable of accomodating changes in soft tissue swelling and should provide enough stability to maintain fracture reduction. The hypothesis is that the sugar tong splint will lead to a reduction in remanipulation rates.
Interventions
Sugar Tong Splint. A sugar tong splint is made of paris of plaster and goes along the posterior aspect of the elbow and extends along the front and back of the forearm and wrist. The sides of the forearm and wrist are left free to allow for swelling. The splint is wrapped with an elastic bandage and immobilizes the elbow, forearm, and wrist. This will be administered by the on call registrar in the emergency department at the time of the initial consultation.
The elastic bandage about the
Sugar Tong Splint. A sugar tong splint is made of paris of plaster and goes along the posterior aspect of the elbow and extends along the front and back of the forearm and wrist. The sides of the forearm and wrist are left free to allow for swelling. The splint is wrapped with an elastic bandage and immobilizes the elbow, forearm, and wrist. This will be administered by the on call registrar in the emergency department at the time of the initial consultation. The elastic bandage about the sugar tong splint will be tightened at week 1 if the splint has loosened. The splint will then be changed to an above elbow cast at the 2 week visit assuming no loss of reduction. This cast will be placed by the clinic nurses in fracture clinic. The cast will be maintained for 3-4 weeks.
Sponsors
Starship Childrens Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
3 Years to 14 Years
Healthy volunteers
No
Inclusion criteria
Pediatric patients age 3-14 years old that 1) are diagnosed with distal third radius fractures with or without associated ulna frctures, 2) require closed reduction of the fracture, 3) are treated with closed reduction at Starship Childrens Hospital, and 4) informed consent is obtained.
Exclusion criteria
1) Open fractures, 2) fractures manipulated outside of Starship Childrens Hospital, 3) nondisplaced fractures or those fractures not requiring reduction, and 4) any irreducible fracture requiring open reduction and/or internal fixation or percutaneous wiring.
Outcome results
None listed