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Research

Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial

Kathy Boutis, Andrew Willan, Paul Babyn, Ron Goeree and Andrew Howard
CMAJ October 05, 2010 182 (14) 1507-1512; DOI: https://doi.org/10.1503/cmaj.100119
Kathy Boutis
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Andrew Willan
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Paul Babyn
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Ron Goeree
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Andrew Howard
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Abstract

Background: Minimally angulated fractures of the distal radius are common in children and have excellent outcomes. We conducted a randomized controlled trial to determine whether the use of a prefabricated splint is as effective as a cast in the recovery of physical function.

Methods: We included 96 children 5 to 12 years of age who were treated for a minimally angulated (≤ 15°) greenstick or transverse fracture of the wrist between April 2007 and September 2009 at a tertiary care pediatric hospital. Participants were randomly assigned to receive either a prefabricated wrist splint or a short arm cast for four weeks. The primary outcome was physical function at six weeks, measured using the performance version of the Activities Scale for Kids. Additional outcomes included the degree of angulation, range of motion, grip strength and complications.

Results: Of the 96 children, 46 received a splint and 50 a cast. The mean Activities Scale for Kids score at six weeks was 92.8 in the splint group and 91.4 in the cast group (difference 1.44, 95% confidence interval [CI] −1.75 to 4.62). Thus, the null hypothesis that the splint is less effective by at least seven points was rejected. The between-group difference in angulation at four weeks was not statistically significant (9.85° in the splint group and 8.20° in the cast group; mean difference 1.65°, 95% CI −1.82° to 5.11°), nor was the between-group differences in range of motion, grip strength and complications.

Interpretation: In children with minimally angulated fractures of the distal radius, use of a splint was as effective as a cast with respect to the recovery of physical function. In addition, the devices were comparable in terms of the maintenance of fracture stability and the occurrence of complications. (ClinicalTrials.gov trial register no. NCT00610220.)

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Canadian Medical Association Journal: 182 (14)
CMAJ
Vol. 182, Issue 14
5 Oct 2010
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Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial
Kathy Boutis, Andrew Willan, Paul Babyn, Ron Goeree, Andrew Howard
CMAJ Oct 2010, 182 (14) 1507-1512; DOI: 10.1503/cmaj.100119

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Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial
Kathy Boutis, Andrew Willan, Paul Babyn, Ron Goeree, Andrew Howard
CMAJ Oct 2010, 182 (14) 1507-1512; DOI: 10.1503/cmaj.100119
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