One Visit-one Brace: Patient and Parent Satisfaction After Treatment for Pediatric Distal Radius Buckle Fractures

Kuba, Megan Hm; Izuka, Byron H; Freese, Krister

doi:10.1097/01.bpo.0000513120.75101.22

Cited by 4 publications

(2 citation statements)

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“…12,13 There is limited evidence that no formal follow-up is associated with higher patient and parent satisfaction. 14 A 2018 study found that serial radiographs in the management of DRBFx were both costly and unnecessary, resulting in no changes in clinical management and increased costs to the health care system. 15 In the UK, The National Institute for Care Excellence (NICE) instituted guidelines in 2016 that advised providers against using rigid immobilization in the management of DRBFx and instead recommended removable wrist splints.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have found no difference in clinical outcomes for children treated with removable wrist splints and no formal follow-up following DRBFx 12,13. There is limited evidence that no formal follow-up is associated with higher patient and parent satisfaction 14. A 2018 study found that serial radiographs in the management of DRBFx were both costly and unnecessary, resulting in no changes in clinical management and increased costs to the health care system 15…”

Section: Discussionmentioning

confidence: 99%

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Trends in Management of Pediatric Distal Radius Buckle Fractures

Lindsay

Holmes

Swarup

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Distal radius buckle fractures (DRBFx) represent nearly half of the pediatric wrist injuries. DRBFx are stable injury patterns that can typically be successfully managed with brief immobilization. The purpose of this study was to evaluate opinions and preferences of pediatric orthopaedic specialists regarding the management of DRBFx. Methods: The POSNA Trauma Quality, Safety, and Value Initiative (QSVI) Committee developed a 20-question survey regarding the treatment of DRBFx in children. The survey was sent twice to all active and candidate POSNA members in June 2020 (n=1487). Questions focused on various aspects of treatment, including type and length of immobilization, follow-up, and radiographs and on potential concerns regarding patient/family satisfaction and pain control, medicolegal concerns, misdiagnosis, and mismanagement. Results: A total of 317 participants completed the survey (response rate=21.3%). In all, 69% of all respondents prefer to use a removable wrist splint, with 76% of those in practice <20 years preferring removable wrist splints compared with 51% of those in practice >20 years (χ2=21.7; P<0.01). Overall, 85% of participants utilize shared decision-making in discussing management options with patients and their families. The majority of participants felt that the risk of complications associated with DRBFx was very low, but concern for misdiagnosis and mismanagement have required some respondents to perform closed or open reductions. Conclusions: In 2020, the majority of respondents treat DRBFx with removable splints (69%) for 3 or fewer weeks (55%), minimal follow-up (85%), and no reimaging (64%). This marks a dramatic shift from the 2012 POSNA survey when only 29% of respondents used removable splinting for DRBFx. Level of Evidence: Level II.

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