Each time she was given a rigid cast (yellow and red) for six weeks. I won the award for having the most accident-prone child, who, on two separate occasions, sustained a wrist fracture whilst rollerblading : a greenstick fracture the first time and a complete break the second. Take-home pointsĪ recent conversation in the office revealed the diversity of childhood wrist fractures and the different ways there are of treating them. There are different types of studies used to answer research questions, for example randomised controlled trials or observational studies. The blog now includes the results of the FORCE study An investigation of a healthcare problem. Revised and republished: 03 February 2022. Page originally published: 18 January 2019. None of the children required surgical intervention during the follow-up period.In this blog, Lynda Ware, our Senior Fellow in General Practice, looks at evidence and practice for different treatments for wrist fractures in children. The primary difference between the groups occurred at week 6 when 5 percent of parents and 12 percent of children in the splint group reported they would have preferred a cast, whereas 60 percent of parents and 68 percent of children in the cast group reported they would have preferred a splint. Based on parental reports, splint use became less frequent by the end of four weeks. Six children had to wear their immobilization device for an additional two weeks because the angulation of their fracture had increased to 25 degrees by the fourth week these children were evenly divided between the two groups. There were also no significant differences between the immobilization devices in the irritation, itching, and discomfort reported. Results: The authors found no significant differences between the groups based on each patient's range of motion, grip strength, and ability to complete activities six weeks after initiation of treatment. Parents completed a weekly diary to record pain scores and compliance with treatment and were contacted three months after treatment to assess recovery. Six weeks after the initial application of the immobilization device, physiotherapists assessed the children's physical function, using single-blinded methodology. Additionally, children with congenital wrist anomalies, coagulopathies, multisystem trauma, multiple injuries to the same limb, or developmental delay were excluded. Children with an injury that was older than five days who had a buckle, open, or pathologic fracture or whose fracture involved the growth plate were excluded from the study. The authors defined 15 degrees or less as translation displacement of 5 mm or less on the frontal plane. The angle of displacement of the bone was determined in the sagittal plane of the radiography. Children in splints were advised to remove the splint only for hygienic reasons. Of the 96 children who met inclusion criteria, 46 were placed in a splint and 50 were placed in a cast, each for four weeks. The Study: The authors enrolled children five to 12 years of age with minimally angulated (15 degrees or less) greenstick or transverse fractures of the distal radius.
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