Cast immobilisation for the treatment of paediatric distal radius fracture: fibreglass versus polyolefin

Zhu, Meng; Lokino, Elvin Salioc; Chan, Cheri Su Hui; Gan, Arlene Jeremie; Ong, Ling Ling; Lim, Kwanghui

doi:10.11622/smedj.2018118

Cited by 7 publications

(8 citation statements)

References 9 publications

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“…Second, this study is limited by the use of a self-reporting questionnaire that has not been validated. With more research focused on improving comfort and overall satisfaction of cast immobilization and innovating new casting material, 8,9,[19][20][21] it would be essential and beneficial for a questionnaire to be developed and validated.…”

Section: Discussionmentioning

confidence: 99%

“…Both fiberglass and HM casts were removed by plaster technicians with the use of a cast cutter, after which patients were given a patient satisfaction questionnaire to complete, with or without assistance from their parents. Due to the lack of validated questionnaires to assess cast experience and comfort, the questions were adopted from Zhu et al and Silva et al 8,9 The questionnaire consisted of 13 questions with 3 sections on water contact (for HM casts only), participation in water (for HM casts only) or outdoor recreational activities, and overall comfort and satisfaction levels (Table 1). We modified the questionnaire to exclude the 2 questions on pain that we felt were not relevant to our study.…”

Section: Methodsmentioning

confidence: 99%

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Improved Comfortability and Satisfaction of Hybrid-mesh Casts in the Conservative Management of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial

Ong,

Lee,

Mishra

et al. 2023

Journal of Pediatric Orthopaedics

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Background:Cast immobilization is the mainstay of treatment for stable pediatric supracondylar humeral fractures (SCHFs). In recent years, a waterproof and breathable hybrid-mesh (HM) cast has emerged and been marketed to address common complaints such as itch, skin irritation, and malodor. Hence, this randomized controlled trial seeks to assess the overall satisfaction, comfort, and clinical outcomes of using HM casts in the conservative treatment of stable pediatric SCHF.Methods:Seventy-nine patients (age range: 1 to 10 y) with modified Gartland’s classification Type I and Type IIa SCHF were recruited and randomized for immobilization with either fiberglass or HM long-arm cast for 3 weeks. During follow-up visits, patients were assessed for any loss of reduction and skin rash. The weight of casts, the presence of cast breakage, the duration of cast application, and removal were recorded. A self-reported patient comfort and satisfaction questionnaire was also administered during the same visit.Results:The final analysis included 38 patients immobilized with fiberglass casts and 39 patients with HM casts. Despite the significantly longer duration required for HM cast removal (4.18±1.25 min vs. 2.25±0.55 min,P<0.001), the HM cast was significantly lighter than its fiberglass counterpart (162.82±23.94 g vs. 203.95±36.52 g,P<0.001). The HM casts have better comfort (4.05±0.887 vs. 3.47±0.951,P=0.007) and satisfaction (3.69±1.055 vs. 3.11±0.953,P=0.012) scores as compared to fiberglass casts for immobilizing pediatric SCHF without compromising clinical outcome.Conclusions:HM casts have better comfort and overall satisfaction as compared to conventional fiberglass casts for immobilizing pediatric SCHF without compromising clinical outcomes.Level of Evidence:Level II—therapeutic studies—investigating the results of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Improved Comfortability and Satisfaction of Hybrid-mesh Casts in the Conservative Management of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial

Ong,

Lee,

Mishra

et al. 2023

Journal of Pediatric Orthopaedics

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“…Most undisplaced or minimally displaced fractures are usually managed conservatively by immobilization in cast for 4-6 weeks. 7 However many patients in whom the fractures are unstable or there are complex fractures and in whom loss of reduction has occurred surgical intervention is needed. In routine orthopedics practice pediatric patients with distal radius fractures are surgically managed if non-surgical management is not able to produce or maintain satisfactory alignment.…”

Section: Introductionmentioning

confidence: 99%

Management of isolated distal end of radius fracture in pediatric age group: An observational study

Phadke¹,

Allamwar²,

Antrolikar³

2021

Asian J Med Sci

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Background: Fractures of the distal radius are one of the common fractures for which pediatric orthopedic consultations are sought. The usual mechanism of injury is fall on outstretched hand seen following a road traffic accident or fall. Most of these fractures are treated either conservatively or by closed reduction and immobilization in cast. In some cases, internal fixation by K-wiring may be required. We conducted this study to analyzed outcome of distal end radius fracture in pediatric age group who were treated by immobilization alone, by closed reduction and immobilization and closed reduction with internal fixation by K-Wire and immobilization in cast. Aims and Objectives: 1. To analyze outcome of distal end radius fracture in pediatric age group. 2. To study complications in children presenting with distal end radius fracture. Materials and Methods: This was an observational study conducted in the department of orthopedics of a tertiary care medical college. 60 pediatric patients with distal radius fractures and treated either by conservative management or by surgical intervention were included in this study on the basis of a predefined inclusion and exclusion criteria. Gender distribution, mean age and mechanism of injury in the affected cases were analyzed. Patients were treated either by immobilization alone, by closed reduction and immobilization and closed reduction with internal fixation by K-Wire and immobilization in cast. Patients were followed up for 8 weeks. Complications and time for complete union was assessed during follow up visits. Functional outcome was assessed by QuickDash Score. Results: Out of these 60 patients there were 52 (86.66%) males and 8 (13.33%) females with a male to female ratio of 1:0.15. The mean age of affected cases in Boys and Girls was found to be 13.09 +/- 2.93 years and 12.5+/- 3.64 years respectively. Dominant hand was involved in 41 (68.33 %) whereas non-dominant hand was involved in remaining 19 (31.66 %) cases. In 16 (26.67%) patients only casting was required whereas closed reduction and casting was done in 25 (41.67%) patients in remaining 19 (31.67%) patients closed reduction and K-Wire fixation was done. 42 (70%) patients had excellent functional outcome whereas 9 (15%) patients had good functional outcome and 9 (15%) patients were found to have satisfactory outcome. 4 (6.66%) patients developed pressure sores, 1 (1.67%) patient had stiffness and there was 1 (1.67%) case of pin site infections. All these complications were successfully managed by conservative means. Conclusion: Fractures of distal end of radius in pediatric age group can be managed successfully either by immobilization alone or by closed reduction and casting. Internal Fixation by K-Wires may be required in some cases.

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“…3,4 In the past few decades, there have been minimal advances and few reports on materials used for nonoperative treatment of distal radius fractures. [5][6][7][8] The primary emphasis has been on optimizing operative treatment of these fractures by means of optimizing surgical techniques, fracturespecific plates, and rehabilitation protocols.Nonoperative management of distal radius fractures typically includes an early period of wrist and elbow immobilization by means of either a sugar-tong splint or a long-arm cast followed by transition to a short-arm cast. In our experience, the transition time to a short-arm cast varies among practices.…”

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confidence: 99%

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confidence: 99%

A Biomechanical Comparison of Fiberglass Casts and 3-Dimensional–Printed, Open-Latticed, Ventilated Casts

Hoogervorst¹,

Knox²,

Tanaka³

et al. 2019

Hand (New York, N,Y.)

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Distal radius fractures are common, with an incidence of 254 to 278 per 100 000 person-years. 1,2 The indications for operative and nonoperative management of these fractures are still subject to debate. Recent systematic reviews and meta-analysis show little difference between the 2 options. 3,4 In the past few decades, there have been minimal advances and few reports on materials used for nonoperative treatment of distal radius fractures. 5-8 The primary emphasis has been on optimizing operative treatment of these fractures by means of optimizing surgical techniques, fracturespecific plates, and rehabilitation protocols. Nonoperative management of distal radius fractures typically includes an early period of wrist and elbow immobilization by means of either a sugar-tong splint or a long-arm cast followed by transition to a short-arm cast. In our experience, the transition time to a short-arm cast varies among practices. The rationale for a short-arm cast is that with early callus formation and fracture consolidation, limited forearm pronation and supination is tolerated and elbow motion is allowed. Nonoperatively treated distal radius fractures are most often immobilized in a fiberglass cast. The drawback of a cast is that patients often complain that it is cumbersome, irritating, and malodorous, and that it interferes with personal hygiene. This is especially problematic with injuries that require prolonged immobilization, such as scaphoid fractures. An emphasis on patient satisfaction has gained more importance recently in the wake of patient-centered reform in health care. New developments in 3-dimensional (3D) printing make it possible to fabricate a patient-specific cast to immobilize the fractured distal radius. These casts use an open-lattice, ventilated design 831341H ANXXX10.

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Cast immobilisation for the treatment of paediatric distal radius fracture: fibreglass versus polyolefin

Cited by 7 publications

References 9 publications

Improved Comfortability and Satisfaction of Hybrid-mesh Casts in the Conservative Management of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial

Improved Comfortability and Satisfaction of Hybrid-mesh Casts in the Conservative Management of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial

Management of isolated distal end of radius fracture in pediatric age group: An observational study

A Biomechanical Comparison of Fiberglass Casts and 3-Dimensional–Printed, Open-Latticed, Ventilated Casts

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