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The standard treatment for children with closed reduction of displaced distal forearm fractures is an immobilization with an upper arm combicast. The hypothesis is that an forearm immobilization with combicast in children 4-16 years might be sufficient.
Children with distal radial or forearm fractures needing closed reduction are eligible for this study. By drawing lots either an immobilization with an upper arm or forearm combicast will be performed. Regular controls after 5, 10, 28 days, 4 weeks and 7 weeks will be performed to check the rate of displacement, consolidation time, wearing comfort and movement of the elbow joint after taking off the cast.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| upper arm combi cast | Active Comparator | standardized treatment |
|
| forearm combi cast | Experimental | Treatment with a forearm combi cast should be a sufficient immobilization |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| combi cast | Device | upper arm or forearm combi cast |
|
| Measure | Description | Time Frame |
|---|---|---|
| secondary displacement of the fracture | radiological evaluation | Significant difference of secondary displaced fractures 28 days after closed reduction of fracture |
| Measure | Description | Time Frame |
|---|---|---|
| Wearing comfort of the two different casts | help in daily life in hours | 5, 10, 28 days, 4 weeks, 7 weeks after closed reduction of fracture |
| Mobilisation of elbow joint after cast removal | Mobility of the elbow joint in degrees (flection and extension measurement) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Georg Staubli, Dr. med | Emergency department, University Children's Hospital Zurich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Hospital | Zurich | 8032 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21629372 | Background | Paneru SR, Rijal R, Shrestha BP, Nepal P, Khanal GP, Karn NK, Singh MP, Rai P. Randomized controlled trial comparing above- and below-elbow plaster casts for distal forearm fractures in children. J Child Orthop. 2010 Jun;4(3):233-7. doi: 10.1007/s11832-010-0250-1. Epub 2010 Mar 17. | |
| 16391244 | Background | Webb GR, Galpin RD, Armstrong DG. Comparison of short and long arm plaster casts for displaced fractures in the distal third of the forearm in children. J Bone Joint Surg Am. 2006 Jan;88(1):9-17. doi: 10.2106/JBJS.E.00131. |
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| ID | Term |
|---|---|
| D011885 | Radius Fractures |
| D050723 | Fractures, Bone |
| ID | Term |
|---|---|
| D005543 | Forearm Injuries |
| D001134 | Arm Injuries |
| D014947 | Wounds and Injuries |
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one Group with upper arm cast one Group with forearm cast
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| 4 weeks and 7 weeks after closed reduction of fracture |
| 11856927 | Background | Boyer BA, Overton B, Schrader W, Riley P, Fleissner P. Position of immobilization for pediatric forearm fractures. J Pediatr Orthop. 2002 Mar-Apr;22(2):185-7. |
| 16414049 | Background | Bhatia M, Housden PH. Re-displacement of paediatric forearm fractures: role of plaster moulding and padding. Injury. 2006 Mar;37(3):259-68. doi: 10.1016/j.injury.2005.10.002. Epub 2006 Jan 18. |
| 21590522 | Background | Katz K, Weigl D, Becker T, Attias J, Bar-On E. Short-term after-effect of forearm cast removal in children. J Orthop Sci. 2011 May;16(3):283-5. doi: 10.1007/s00776-011-0054-2. Epub 2011 Mar 29. |
| 32940750 | Derived | Seiler M, Heinz P, Callegari A, Dreher T, Staubli G, Aufdenblatten C. Short and long-arm fiberglass cast immobilization for displaced distal forearm fractures in children: a randomized controlled trial. Int Orthop. 2021 Mar;45(3):759-768. doi: 10.1007/s00264-020-04800-w. Epub 2020 Sep 17. |