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VOL. 8, ISSUE 3 (2022)
A comparative study: Removable splinting versus casting for wrist torus fractures in children
Authors
Shah A B, Limbu A, Baral P, Pradhan S R
Abstract
Background: Forearm fractures account for 40% of pediatric long bone fractures. Buckle or Torus fractures are the most common forearm fractures in children, and these are stable fractures, where fracture occurs in the transition zone between woven metaphyseal bone and lamellar diaphyseal bone. Treatment of these torus fractures differ from each hospital. Options include rigid full below elbow cast for 3 weeks, removable pre-fabricated splints, back-slabs, bandages and soft cast. There has also been some concern among clinicians about increased pain and re-fractures occurring in children treated with immobilisation. The purpose of this study is to determine whether rigid cast could maintain the reduction of distal pediatric torus fractures as well as a removable splint in a prospective, randomized manner. Hence, we compared these two methods with respect to functional outcome, delayed union, nonunion, malunion and related complications, so that we have a better and clear evidence and guideline for managing pediatric torus fractures. Methods: A total of 110 children eligible to participate in the study were included in the study and randomized into 2 groups (55 each). In the 1st group above elbow splint was applied for 6 weeks and in the second group cast was applied after fracture reduction and subsequently followed up. Assessment of fracture was done regular interval of 1 week, 3 week, and 6 week in terms of union, activity scale for kids, safety and neurovascular compromise. Results: There was no statistically significant relation in elbow flexion (p value - 0.397). Mean loss of flexion was 9.44 degrees (S.D. – 9.22) in Cast and 11.94 degrees (S.D. – 8.25) in Removable Splint group. There was no statistically significant difference in limitation in pronation/supination (p value -0.814). Mean loss of pronation was 8.55 ± 6.431 and 7.81 ± 5.613 in Removable splint and Cast group respectively and the mean loss of supination was 8.45 ± 5.763 and 6.82 ± 5.302 in the Removable splint and Cast group respectively. Conclusion: Removable splint is safe and as effective as Cast for 6 weeks in the treatment of Torus fractures in children. Both methods were identical in terms functional outcome, maintenance of reduction and other complications and time to union.
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Pages:64-68
How to cite this article:
Shah A B, Limbu A, Baral P, Pradhan S R "A comparative study: Removable splinting versus casting for wrist torus fractures in children". International Journal of Medical and Health Research, Vol 8, Issue 3, 2022, Pages 64-68
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