Supracondylar humeral fractures are the most common elbow fractures in children and cast immobilization continues to remain as the recommended treatment for modified Gartland's classification Type I and Type IIa injuries. Apart from plaster of Paris and fibreglass casts, the use of waterproof, tubular hybrid mesh (HM) casts have been gaining traction for cast immobilization. Although the use of HM cast has been reported to have similar clinical outcomes and overall patient satisfaction scores to the fibreglass cast, the results of the recent studies are only limited and generalizable only to paediatric distal radius fractures. As the application method of HM and fibreglass casts are fundamentally different, it has not been reported if the difference in application duration between the cast materials is significant and its potential implications in outpatient clinic operation. Hence, through a randomized controlled trial, this study primarily aims to investigate if the clinical outcomes, patient satisfaction and duration of cast application with the HM casts would be comparable with fibreglass casts in children with supracondylar humeral fractures. Through this study, the investigators hope to evaluate the advantages and disadvantages of the respective casting material which may better aid physicians in deciding a more appropriate cast material for treating paediatric supracondylar humeral fractures with cast immobilization and the implications of casting duration on clinic operations.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
79
Subjects assigned to this arm will be treated via cast immobilisation with the use of HM casts.
Subjects assigned to this arm will be treated via cast immobilisation with the use of Fibreglass casts.
KK Women's and Children Hospital
Singapore, Singapore
Clinical Outcome - Loss of Reduction
Based on the radiographs taken 4 weeks after casting, the Baumann's angle will used to assess for any loss of reduction.
Time frame: 4 weeks post-casting
Comfort and Overall Satisfaction
Through a questionnaire, the patients and their parents will be asked to rate the patients' experience on adaptability, weight of the cast, itch, heat, sweatiness, smell, comfort and overall satisfaction. For each question, on the scales of 1 to 5, the rating of 1 would designate as the least desirable option and the rating of 5 being the most desirable option.
Time frame: 4 weeks post-casting
Presence of Skin Rash
The presence of skin rash will be assessed by the study team member upon cast removal.
Time frame: 4 weeks post-casting
Duration of Cast Application
The duration of each cast application with the respective cast materials will be recorded and analysed.
Time frame: During Procedure (Cast Application - First Visit)
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