It is recognized that fractures of the distal radius and forearm occur in approximately one in 100 children and adolescents every year. Though closed manipulation and cast immobilization of displaced injuries is the mainstay of treatment in the majority of cases, the optimal type of cast remains debatable. Though well-molded casts theoretically provide the best ability to maintain fracture alignment, risks of circumferential immobilization in acute injuries include neurovascular compromise. Splitting, or bivalving, casts may reduce these risks, but the effect on fracture stability is unknown. The proposed investigation seeks to address the simple question of whether circumferential or bivalved casts provide the best outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
202
Circumferential cast will be applied following closed reduction and then bivalved using a cast saw
Circumferential cast will be applied following closed reduction
Childrens Hospital Boston
Boston, Massachusetts, United States
Loss of Radius Fracture Reduction
The number of participants that experienced radiographic loss of reduction by four weeks post-randomization.
Time frame: 4 weeks post-randomization
Compartment Syndrome or Neurovascular Compromise, Saw Burns and/or Lacerations
The number of participants that experienced compartment syndrome or neurovascular compromise, saw burn and/or laceration within four weeks post-randomization.
Time frame: Up to 4 weeks post-randomization
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