Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Oct 5;182(14):1507-12.
doi: 10.1503/cmaj.100119. Epub 2010 Sep 7.

Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial

Kathy Boutis  1 , Andrew Willan, Paul Babyn, Ron Goeree, Andrew Howard
Affiliations
Randomized Controlled Trial

Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial

Kathy Boutis et al. CMAJ. .

Abstract

Background: Minimally angulated fractures of the distal radius are common in children and have excellent outcomes. We conducted a randomized controlled trial to determine whether the use of a prefabricated splint is as effective as a cast in the recovery of physical function.

Methods: We included 96 children 5 to 12 years of age who were treated for a minimally angulated (≤ 15°) greenstick or transverse fracture of the wrist between April 2007 and September 2009 at a tertiary care pediatric hospital. Participants were randomly assigned to receive either a prefabricated wrist splint or a short arm cast for four weeks. The primary outcome was physical function at six weeks, measured using the performance version of the Activities Scale for Kids. Additional outcomes included the degree of angulation, range of motion, grip strength and complications.

Results: Of the 96 children, 46 received a splint and 50 a cast. The mean Activities Scale for Kids score at six weeks was 92.8 in the splint group and 91.4 in the cast group (difference 1.44, 95% confidence interval [CI] -1.75 to 4.62). Thus, the null hypothesis that the splint is less effective by at least seven points was rejected. The between-group difference in angulation at four weeks was not statistically significant (9.85° in the splint group and 8.20° in the cast group; mean difference 1.65°, 95% CI -1.82° to 5.11°), nor was the between-group differences in range of motion, grip strength and complications.

Interpretation: In children with minimally angulated fractures of the distal radius, use of a splint was as effective as a cast with respect to the recovery of physical function. In addition, the devices were comparable in terms of the maintenance of fracture stability and the occurrence of complications. (ClinicalTrials.gov trial register no. NCT00610220.).

PubMed Disclaimer

Figures

Figure 1
Figure 1
Recruitment of study patients. *Numbers total more than 522 because some children had more than one exclusion criterion. R = randomization.
See this image and copyright information in PMC

Comment in

References

    1. Bohm ER, Bubbar V, Yong Hing K, et al. Above and below-the-elbow plaster casts for distal forearm fractures in children. A randomized controlled trial. J Bone Joint Surg Am. 2006;88:1–8. - PubMed
    1. Bachman D, Santora S. Orthopedic trauma. In: Fleisher G, Ludwig S, Henretig FM, et al., editors. Textbook of pediatric emergency medicine. Philadelphia (PA): Lippincott Williams & Wilkins; 2000. pp. 1455–7.
    1. Al Ansari K, Howard A, Seeto B, et al. Minimally angulated pediatric wrist fractures: Is casting without manipulation enough? CJEM. 2007;9:9–15. - PubMed
    1. Do TT, Strub WM, Foad SL, et al. Reduction versus remodeling in pediatric distal forearm fractures: a preliminary cost analysis. J Pediatr Orthop B. 2003;12:109–15. - PubMed
    1. Waters PM. Distal radius and ulna fractures. In: Beaty JH, Kasser JR, editors. Fractures in children. Philadelphia (PA): Lippincott Williams & Wilkins; 2001.

Publication types

Associated data