![]() ![]() 33% of control group had problems with treatment c/w 13% of the home group. Parent satisfaction (VAS) Preference for future treatment ROM at 6/52ĩ5% of the home and 89% of the control group reviewed at 6/52. Removeable backslab applied with removal at 3/52, home versus hospitalįollow-up at 6/52, questionnaire, examination and repeat x rayĮxcluded-pathological fracture, previous injury to that wrist, lack of parental consent or understanding 101 Referred to the study, 14 excludedĨ7 Remaining patients randomised by computer generated random number sheet to home (40) or hospital (control) (47) group. No complaints of pain or lack of functional recoveryġ54 Children with distal radius buckle fractures identified September 1997 to May 1998. Individual determination of length of time to remain in POPġ0% Required further medical advice BUT for a rash, loose POP, POP that fell off, and one mistaken reattendance at fracture clinic Telephone follow-up was at 4/52ġ00% Satisfaction with treatment and outcome Written and verbal instructions (also sent to GP). No refracture at 6/12 follow-up (34/42 splint, 41/45 POP)Ĥ1 Patients with buckle fracture distal radius age 12 years were consecutively enrolled at 1st fracture clinic and treated with Dynacast Prelude backslab. Secondary (multiple)- ASKp at 7, 20 and 28 days, patient and parent satisfaction at 28 days, refracture at 6/12ĪSKp at day 14-splint 93.77 (87.26–99.15) Researchers could not be blinded (certain questions on the ASKp made this impossible) High loss to follow-up/withdrawal AND No intention to treat analysis Cast removal at 3/52Įxcluded 2nd fracture of same limb, bilateral fractures, metabolic bone disease, language barrier, home outwith catchment areaĨ7 Included in final analysis-42 splint, 45 POP (losses: 15 splint, 11 POP) telephone follow-up at 4–5/52ġ17 Questionnaires completed-69 soft cast, 48 rigid castġ00% Recovery of function both groups at follow-upĬomplication rate 10.4% rigid cast, 1.4% soft cast (p = 0.035)ġ13 Children (6–15 years) with distal radius +/or ulna buckle fracture from 08/02 to 09/03īlock randomised to BE POP or removable plaster splint. Randomisation dependent on month of attendanceĬast removal at 3/52. In both groups all fractures were united clinically and on x ray with no loss of positionĬost of treatment with POP-£116.98, with splint-£65.75ġ31 Children aged 2–12 years with buckle fractures randomised to hard (BE full POP) or soft (Cellacast) casts between July and October 2004 (at fracture clinic). Two excluded, one did not consent, one had a greenstick fractureĬlinical and radiological recovery at 3/52 Loss to follow-up-four POP and 18 splint leaving 81 POP and 98 splint. Variation in number of and timing of x raysĬonclusion states need for one follow-up study but with no evidence for thisĢ01 Children 2–15 years with buckle fracture of the distal radius over 6/12 at fracture clinic were (quasi) randomised to full Colles’ type cast or futura splint Of 65 patients followed up for 4/52, all had recorded adequate healing either clinically, on x ray, or both Number of, and timing of, follow up x ray Expert opinion level 5 on need for follow-up Two-part retrospective notes review-level 4. Further research is neededħ0 Children with buckle fractures of the wrist who attended an urban tertiary care fracture clinic between February 19 No short-term deformity was found in all four trialsįew and some poorer quality studies includedĬonclusion: Limited evidence for removable splint but? best type of splintage. Relevant Paper(s) Author, date and countryĤ Randomised/quasi-randomised trials of children with buckle fractures-comparison of removable splint versus POP (Davidson, Plint, West, Symons) Google scholar-one extra relevant article found Medline-1067 articles found, seven relevant articles OR exp treatment outcome$/OR exp recovery of function/Ĭochrane Database 2009 – "buckle" "radius" "fractures" OR exp child, preschool/OR exp infant OR exp adolescent/OR infant$.mp. OR exp fracture$, closed/exp *Wrist/pa, ab, su, ra OR exp *Forearm/ab, su, ra, pa. OR exp ulna fracture$/OR (forearm adj 5 fracture$).mp. ![]() Your next question is whether he really needs fracture clinic follow-up with repeat x ray(s) or whether this type of fracture will always heal with no risk of loss of position or residual functional deficit.Įxp radius fracture$/OR wrist fracture$.mp. You apply a removable brace as you have recently read a 2008 BestBET that suggests that it will support healing as much as a full cast. His x ray shows a buckle fracture of the distal radius. ![]() Is necessary ? Clinical ScenarioĪ 6-year-old child presents to the ED with a painful wrist following a fall. ![]()
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