The purpose of this study is to determine whether a sugar-tong splint is as effective as a long-arm cast in maintaining reduction of pediatric forearm shaft fractures in a randomized, prospective manner. Consented participants will be randomly assigned to be treated with either a sugar-tong splint or a long-arm cast (both standard of care treatments) in REDCap. Each participant will have a 50/50 chance of being assign to either treatment.
Forearm fractures are very common in the pediatric population and can often be treated with closed reduction and immobilization. Immobilization techniques include long-arm casting, short-arm casting and sugar-tong splinting. At the time of injury casts are usually split into two using a cast saw, known as bivalving, to allow for swelling and are overwrapped at a later time. By design sugar-tong splints allow for swelling and are overwrapped or converted to a cast at a later time. Traditionally long-arm casts have been used as the standard mode of immobilization for forearm fractures. Recent evidence demonstrates that long-arm casting is equivalent to better tolerated short-arm casting as an immobilization choice for distal third forearm fractures.1 Further work has shown that sugar-tong splints are also appropriate for treatment of distal third forearm fractures. No study has compared the efficacy of using a long-arm cast versus a sugar-tong splint for treatment of forearm shaft fractures.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
A long-arm cast is a circumferential wrapping of the arm from the fingers to above the elbow with casting material.
A sugar-tong splint is the application of hard splinting material on the front and back of the arm.
St. Louis Children's Hospital
St Louis, Missouri, United States
Radiographic measurements
Measure sagittal angulation
Time frame: 1 week
Radiographic measurements
Measure sagittal angulation
Time frame: 2 weeks
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Measure sagittal angulation
Time frame: 4 weeks
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Measure sagittal angulation
Time frame: 6 weeks
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Coronal angulation
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Coronal angulation
Time frame: 2 weeks
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Coronal angulation
Time frame: 4 weeks
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Coronal angulation
Time frame: 6 weeks
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Displacement
Time frame: 1 week
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Time frame: 2 weeks
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Displacement
Time frame: 4 weeks
Radiographic measurements
Displacement
Time frame: 6 weeks
Radiographic measurements
Percent displacement
Time frame: 1 week
Radiographic measurements
Percent displacement
Time frame: 2 weeks
Radiographic measurements
Percent displacement
Time frame: 4 weeks
Radiographic measurements
Percent displacement
Time frame: 6 weeks
Clinical follow-up
Treatment information
Time frame: 1 week
Clinical follow-up
Treatment information
Time frame: 2 weeks
Clinical follow-up
Treatment information
Time frame: 4 weeks
Clinical follow-up
Treatment information
Time frame: 6 weeks