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
Meta-Analysis
. 2018 Dec 19;12(12):CD012470.
doi: 10.1002/14651858.CD012470.pub2.

Interventions for treating wrist fractures in children

Helen Hg Handoll  1 , Joanne Elliott, Zipporah Iheozor-Ejiofor, James Hunter, Alexia Karantana
Affiliations
Meta-Analysis

Interventions for treating wrist fractures in children

Helen Hg Handoll et al. Cochrane Database Syst Rev. .

Abstract

Background: Wrist fractures, involving the distal radius, are the most common fractures in children. Most are buckle fractures, which are stable fractures, unlike greenstick and other usually displaced fractures. There is considerable variation in practice, such as the extent of immobilisation for buckle fractures and use of surgery for seriously displaced fractures.

Objectives: To assess the effects (benefits and harms) of interventions for common distal radius fractures in children, including skeletally immature adolescents.

Search methods: We searched the Cochrane Bone, Joint and Muscle Trauma Group's Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, trial registries and reference lists to May 2018.

Selection criteria: We included randomised controlled trials (RCTs) and quasi-RCTs comparing interventions for treating distal radius fractures in children. We sought data on physical function, treatment failure, adverse events, time to return to normal activities (recovery time), wrist pain, and child (and parent) satisfaction.

Data collection and analysis: At least two review authors independently performed study screening and selection, 'Risk of bias' assessment and data extraction. We pooled data where appropriate and used GRADE for assessing the quality of evidence for each outcome.

Main results: Of the 30 included studies, 21 were RCTs, seven were quasi-RCTs and two did not describe their randomisation method. Overall, 2930 children were recruited. Typically, trials included more male children and reported mean ages between 8 and 10 years. Eight studies recruited buckle fractures, five recruited buckle and other stable fractures, three recruited minimally displaced fractures and 14 recruited displaced fractures, typically requiring closed reduction, typically requiring closed reduction. All studies were at high risk of bias, mainly reflecting lack of blinding. The studies made 14 comparisons. Below we consider five prespecified comparisons:Removable splint versus below-elbow cast for predominantly buckle fractures (6 studies, 695 children)One study (66 children) reported similar Modified Activities Scale for Kids - Performance scores (0 to 100; no disability) at four weeks (median scores: splint 99.04; cast 99.11); low-quality evidence. Thirteen children needed a change or reapplication of device (splint 5/225; cast 8/219; 4 studies); very low-quality evidence. One study (87 children) reported no refractures at six months. One study (50 children) found no between-group difference in pain during treatment; very low-quality evidence. Evidence was absent (recovery time), insufficient (children with minor complications) or contradictory (child or parent satisfaction). Two studies estimated lower healthcare costs for removable splints.Soft or elasticated bandage versus below-elbow cast for buckle or similar fractures (4 studies, 273 children)One study (53 children) reported more children had no or only limited disability at four weeks in the bandage group; very low-quality evidence. Eight children changed device or extended immobilisation for delayed union (bandage 5/90; cast 3/91; 3 studies); very low-quality evidence. Two studies (139 children) reported no serious adverse events at four weeks. Evidence was absent, insufficient or contradictory for recovery time, wrist pain, children with minor complications, and child and parent satisfaction. More bandage-group participants found their treatment convenient (39 children).Removal of casts at home by parents versus at the hospital fracture clinic by clinicians (2 studies, 404 children, mainly buckle fractures)One study (233 children) found full restoration of physical function at four weeks; low-quality evidence. There were five treatment changes (home 4/197; hospital 1/200; 2 studies; very low-quality evidence). One study found no serious adverse effects at six months (288 children). Recovery time and number of children with minor complications were not reported. There was no evidence of a difference in pain at four weeks (233 children); low-quality evidence. One study (80 children) found greater parental satisfaction in the home group; low-quality evidence. One UK study found lower healthcare costs for home removal.Below-elbow versus above-elbow casts for displaced or unstable both-bone fractures (4 studies, 399 children)Short-term physical function data were unavailable but very low-quality evidence indicated less dependency when using below-elbow casts. One study (66 children with minimally displaced both-bone fractures) found little difference in ABILHAND-Kids scores (0 to 42; no problems) (mean scores: below-elbow 40.7; above-elbow 41.8); very low-quality evidence. Overall treatment failure data are unavailable, but nine of the 11 remanipulations or secondary reductions (366 children, 4 studies) were in the above-elbow group; very low-quality evidence. There was no refracture or compartment syndrome at six months (215 children; 2 studies). Recovery time and overall numbers of children with minor complications were not reported. There was little difference in requiring physiotherapy for stiffness (179 children, 2 studies); very low-quality evidence. One study (85 children) found less pain at one week for below-elbow casts; low-quality evidence. One study found treatment with an above-elbow cast cost three times more in Nepal.Surgical fixation with percutaneous wiring and cast immobilisation versus cast immobilisation alone after closed reduction of displaced fractures (5 studies, 323 children)Where reported, above-elbow casts were used. Short-term functional outcome data were unavailable. One study (123 children) reported similar ABILHAND-Kids scores indicating normal physical function at six months (mean scores: surgery 41.9; cast only 41.4); low-quality evidence. There were fewer treatment failures, defined as early or problematic removal of wires or remanipulation for early loss in position, after surgery (surgery 20/124; cast only 41/129; 4 studies; very low-quality evidence). Similarly, there were fewer serious advents after surgery (surgery 28/124; cast only 43/129; 4 studies; very low-quality evidence). Recovery time, wrist pain, and satisfaction were not reported. There was lower referral for physiotherapy for stiffness after surgery (1 study); very low-quality evidence. One USA study found similar treatment costs in both groups.

Authors' conclusions: Where available, the quality of the RCT-based evidence on interventions for treating wrist fractures in children is low or very low. However, there is reassuring evidence of a full return to previous function with no serious adverse events, including refracture, for correctly-diagnosed buckle fractures, whatever the treatment used. The review findings are consistent with the move away from cast immobilisation for these injuries. High-quality evidence is needed to address key treatment uncertainties; notably, some priority topics are already being tested in ongoing multicentre trials, such as FORCE.

PubMed Disclaimer

Conflict of interest statement

Helen HG Handoll: None known. Joanne Elliott: None known. Zipporah Iheozor‐Ejiofor: None known. James Hunter: None known. Alexia Karantana: None known

Figures

1
1
Study flow diagram
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD012470

References

References to studies included in this review

Bohm 2006 {published data only}
    1. Bohm ER, Bubbar V, Yong Hing K, Dzus A. Above and below‐the‐elbow plaster casts for distal forearm fractures in children. A randomized controlled trial. Journal of Bone and Joint Surgery. American Volume 2006;88(1):1‐8. - PubMed
Boutis 2010 {published data only}
    1. Boutis K. Cast versus splint in children with acceptably angulated wrist fractures. clinicaltrials.gov/ct2/show/NCT00610220 (first received 7 February 2008).
    1. Boutis K, Willan A, Babyn P, Goeree R, Howard A. Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial. Canadian Medical Association Journal 2010;182(14):1507‐12. - PMC - PubMed
    1. Howard W, Willan A, Boutis K. A randomised controlled trial of cast versus wrist splint in children with acceptably angulated wrist fractures [abstract]. Journal of Bone and Joint Surgery. British Volume 2011;93(SUPP IV):578.
    1. Price CT. A splint was not inferior to a cast for distal radial fracture in children: Commentary. Journal of Bone and Joint Surgery 2011;93(10):970. - PubMed
    1. Keyserlingk C, Boutis K, Willan AR, Hopkins RB, Goeree R. Cost‐effectiveness analysis of cast versus splint in children with acceptably angulated wrist fractures. International Journal of Technology Assessment in Health Care 2011;27(2):101‐7. - PubMed
Boyer 2002 {published data only}
    1. Boyer BA, Overton B, Schrader W, Riley P, Fleissner P. Position of immobilization for pediatric forearm fractures. Journal of Pediatric Orthopaedics 2002;22(2):185‐7. - PubMed
Colaris 2012 {published data only}
    1. Colaris J. Undislocated distal both‐bone forearm fractures in children. clinicaltrials.gov/ct2/show/NCT00397995 (first received 10 November 2006).
    1. Colaris JW, Biter LU, Allema JH, Bloem RM, Ven CP, Vries MR, et al. Below‐elbow cast for distal fractures of radius and ulna: A multicenter randomized study in children. Nederlands Tijdschrift Voor Geneeskunde 2012;156:1107‐11.
    1. Colaris JW, Biter LU, Allema JH, Bloem RM, Ven CP, Vries MR, et al. Below‐elbow cast for metaphyseal both‐bone fractures of the distal forearm in children: A randomised multicentre study. Injury 2012;43(7):1107‐11. - PubMed
Colaris 2013a {published data only}
    1. Colaris J. Dislocated stable distal both‐bone forearm fractures in children. clinicaltrials.gov/ct2/show/NCT00397852 (first received 10 November 2006).
    1. Colaris JW, Allema JH, Biter LU, Vries MR, Ven CP, Bloem RM, et al. Re‐displacement of stable distal both‐bone forearm fractures in children: a randomised controlled multicentre trial. Injury 2013;44(4):498‐503. - PubMed
Davidson 2001 {published data only}
    1. Davidson JS, Brown DJ, Barnes SN, Bruce CE. Simple treatment for torus fractures of the distal radius. Journal of Bone and Joint Surgery. British Volume 2001;83(8):1173‐5. - PubMed
Derksen 2011 {published data only}
    1. Derksen RJ, Commandeur JP, Deij R, Breederveld RS. Swim cast versus traditional cast in pediatric distal radius fractures: a prospective randomized controlled trial. Journal of Children's Orthopaedics 2013;7(2):117‐21. - PMC - PubMed
    1. Derksen RJ, Commandeur JP, Walet W, Deij R, Breederveld RS. Swimcast wrist immobilization (SWIM) trial. Comparison of waterproof versus conventional cast for pediatric distal radius fractures [abstract]. European Journal of Trauma and Emergency Surgery 2011;37:S135.
Ghoneem 2003 {published data only}
    1. Ghoneem H. Pediatric displaced distal forarm fractures: avoiding failure of treatment (abstract). Journal of Bone and Joint Surgery. British Volume 2003;85(SUPP III):262‐3.
Gibbons 1994 {published data only}
    1. Gibbons CL, Woods DA, Pailthorpe C, Carr AJ, Worlock P. The management of isolated distal radius fractures in children. Journal of Pediatric Orthopaedics 1994;14(2):207‐10. - PubMed
    1. Gibbons CL, Woods DA, Pailthorpe C, Carr AJ, Worlock P. The management of isolated distal radius fractures in children [abstract]. Journal of Bone and Joint Surgery. British Volume 1994;76(Suppl):38. - PubMed
Gupta 1990 {published data only}
    1. Gupta RP, Danielsson LG. Dorsally angulated solitary metaphyseal greenstick fractures in the distal radius: Results after immobilization in pronated, neutral, and supinated position. Journal of Pediatric Orthopaedics 1990;10(1):90‐2. - PubMed
Hamilton 2013 {published data only}
    1. Hamilton TW, Hutchings L, Alsousou J, Tutton E, Hodson E, Smith CH, et al. The treatment of stable paediatric forearm fractures using a cast that may be removed at home: comparison with traditional management in a randomised controlled trial. Bone & Joint Journal 2013;95‐B(12):1714‐20. - PubMed
    1. Willett K. Self cast removal at the child's home. www.isrctn.com/ISRCTN55089523 (first received 13 August 2008).
Inglis 2013 {published data only}
    1. Abson S, Williams N, Inglis M, Antoniou G, Cundy P. Resident versus attending surgeons in achieving and maintaining fracture reduction in pediatric distal radius fractures. Journal of Pediatric Orthopaedics 2016;36(5):478‐82. - PubMed
    1. Inglis M, McCelland B, Sutherland L, Cundy P. Fiberglass versus plaster of paris casts for paediatric forearm fractures. an investigation of clinical outcomes and patient satisfaction [abstract]. Journal of Bone and Joint Surgery.British Volume 2012;94(SUPP XXIII):140.
    1. Inglis M, McClelland B, Sutherland LM, Cundy PJ. Synthetic versus plaster of Paris casts in the treatment of fractures of the forearm in children: a randomised trial of clinical outcomes and patient satisfaction. Bone & Joint Journal 2013;95‐B(5):1285‐9. - PubMed
Jones 2001 {unpublished data only}
    1. Jones S, Smith I, Jones MW. Treatment of distal radius buckle fractures [Poster abstract 41]. British Orthopaedic Congress 2001.
    1. Smith I. The management of torus fractures of the distal radius. National Research Register 2001, issue 2.
Karimi 2013 {published data only}
    1. Karimi Mobarakeh M, Nemati A, Noktesanj R, Fallahi A, Safari S. Application of removable wrist splint in the management of distal forearm torus fractures. Trauma Monthly 2013;17(4):370‐2. - PMC - PubMed
Khan 2010 {published data only}
    1. Khan S. Closed reduction of distal forearm fractures by pediatric emergency medicine physicians: a prospective study. clinicaltrials.gov/ct2/show/NCT01101607 (first received 12 April 2010).
    1. Khan S, Sawyer J, Pershad J. Closed manipulation of distal radial fractures by pediatric emergency physicians. Pediatric Emergency Care 2009; American Academy of Pediatrics, Section on Emergency Medicine, Scientific Abstract Presentations, AAP National Conference and Exhibition; 2009 Oct 16; Washington (DC). American Academy of Pediatrics, 2009; Vol. 709.
    1. Khan S, Sawyer J, Pershad J. Closed reduction of distal forearm fractures by pediatric emergency physicians. Academic Emergency Medicine 2010;17:1169‐74. - PubMed
Kropman 2010 {published data only}
    1. Hammacher ER. Treatment of greenstick forearm fractures in children using bandages or cast therapy. apps.who.int/trialsearch/Trial2.aspx?TrialID=NTR393 (first received 21 September 2005).
    1. Kropman RH, Bemelman M, Segers MJ, Hammacher ER. Treatment of impacted greenstick forearm fractures in children using bandage or cast therapy: a prospective randomized trial. Journal of Trauma 2010;68(2):425‐8. - PubMed
Levy 2015 {published data only}
    1. Levy J, Ernat J, Song D, Cook JB, Judd D, Shaha S. Outcomes of long‐arm casting versus double‐sugar‐ tong splinting of acute pediatric distal forearm fractures. Journal of Pediatric Orthopaedics 2015;35(1):11‐7. - PubMed
McLauchlan 2002 {published data only}
    1. Gambhir AK, Fischer J, Waseem M, Robb JE, Maclauchlan GJ, Annan IH. Management of completely displaced metaphyseal fractures of the distal radius in children (multiple letters). Journal of Bone and Joint Surgery. British Volume 2003;85:463. - PubMed
    1. McLauchlan GJ, Cowan B, Annan IH, Macnicol MF, Robb JE. A randomised trial of treatment of completely displaced distal radial fractures in children [abstract]. Journal of Bone and Joint Surgery. British Volume 2000;82(Suppl 1):63.
    1. McLauchlan GJ, Cowan B, Annan IH, Robb JE. Management of completely displaced metaphyseal fractures of the distal radius in children. A prospective, randomised controlled trial. Journal of Bone and Joint Surgery. British Volume 2002;84:413‐7. - PubMed
    1. McLauchlan GJ, Cowan B, Annan IH, Robb JE, Price CT. The addition of a Kirschner wire to an above‐the‐elbow cast prevented loss of position in displaced fractures of the distal radius in children. Journal of Bone and Joint Surgery. American Volume 2002;84:2109. - PubMed
Miller 2005 {published data only}
    1. Miller B, Waters PM, Taylor B. A prospective, randomized study of displaced pediatric metaphyseal distal radius fracture: cast immobilization versus percutaneous pin fixation [abstract]. American Academy of Orthopaedic Surgeons 67th Annual Meeting; 2000; Orlando (FL). 2000.
    1. Miller BS, Taylor B, Widmann RF, Bae DS, Snyder BD, Waters PM. Cast immobilization versus percutaneous pin fixation of displaced distal radius fractures in children: a prospective, randomized study. Journal of Pediatric Orthopaedics 2005;25(4):490‐4. - PubMed
Oakley 2008 {published data only}
    1. Oakley E. Comparison of two methods of immobilising torus fractures of the distal forearm. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12606000126516 (first received 6 April 2006).
    1. Oakley EA, Ooi KS, Barnett PL. A randomized controlled trial of 2 methods of immobilizing torus fractures of the distal forearm. Pediatric Emergency Care 2008;24(2):65‐70. - PubMed
Paneru 2010 {published data only}
    1. Paneru SR, Rijal R, Shrestha BP, Nepal P, Khanal GP, Karn NK, et al. Randomized controlled trial comparing above‐ and below‐elbow plaster casts for distal forearm fractures in children. Journal of Children's Orthopaedics 2010;4(3):233‐7. - PMC - PubMed
Plint 2006 {published data only}
    1. Anonymous. Splint equal to cast for wrist buckle fracture in children [POEM]. Journal of Family Practice 2006;55(6):476. - PubMed
    1. Plint AC, Perry JJ, Correll R, Gaboury I, Lawton L. A randomized, controlled trial of removable splinting versus casting for wrist buckle fractures in children. Pediatrics 2006;117(3):691‐7. - PubMed
Pountos 2010 {published data only}
    1. Pountos I, Clegg J, Siddiqui A. Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single blind study. Journal of Children's Orthopaedics 2010;4(4):321‐6. - PMC - PubMed
Schulte 2014 {published and unpublished data}
    1. Garcia D. Additional data [personal communication]. Email to: J Elliott 21 June 2017 and 9 August 2017.
    1. Schulte D, Habernig S, Zuzak T, Staubli G, Altermatt S, Horst M, et al. Forearm fractures in children: split opinions about splitting the cast. European Journal of Pediatric Surgery 2014;24(2):163‐7. - PubMed
Silva 2016 {published data only}
    1. Silva M. Waterproof casting for pediatric distal radius fractures. clinicaltrials.gov/ct2/show/NCT02095106 (first received 24 March 2014).
    1. Silva M, Avoian T, Warnock RS, Sadlik G, Ebramzadeh E. It is not just comfort: waterproof casting increases physical functioning in children with minimally angulated distal radius fractures. Journal of Pediatric Orthopaedics. Part B 2017;26:417‐23. - PubMed
Stevenson 2013 {published and unpublished data}
    1. Antoniou G. Additional data [personal communication]. Email to: J Elliott 28 April 2017.
    1. Stevenson AW, Gahukamble AD, Antoniou G, Pool B, Sutherland LM, Cundy P. Waterproof cast liners in paediatric forearm fractures: a randomized trial. Journal of Childrens Orthopaedics 2013;7(2):123‐30. - PMC - PubMed
Symons 2001 {published data only}
    1. Mehlman CT. Home removal of a backslab 3 weeks after buckle fracture of the distal radius was as safe as removal at a fracture clinic. Journal of Bone and Joint Surgery. American Volume 2002;84(5):883.
    1. Symons S, Rowsell M, Bhowal B, Dias JJ. Hospital versus home management of children with buckle fractures of the distal radius. A prospective, randomised trial. Journal of Bone and Joint Surgery. British Volume 2001;83:556‐60. - PubMed
Webb 2006 {published data only}
    1. Kumar G. Comparison of short and long arm plaster casts for displaced fractures in the distal third of the forearm in children (letter). Journal of Bone and Joint Surgery. American Volume 2006;88(8):1888‐9. - PubMed
    1. 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. Journal of Bone and Joint Surgery. American Volume 2006;88:9‐17. - PubMed
West 2005 {published data only}
    1. West S, Andrews J, Alderman P. Treatment of buckle fractures in bandage versus plaster: a randomised prospective trial [abstract]. Journal of Bone and Joint Surgery. British Volume 2003;85(Suppl III):276.
    1. West S, Andrews J, Bebbington A, Ennis O, Alderman P. Buckle fractures of the distal radius are safely treated in a soft bandage: a randomized prospective trial of bandage versus plaster cast. Journal of Pediatric Orthopaedics 2005;25(3):322‐5. - PubMed
    1. West S, Andrews J, Bebbington A, Ennis O, Alderman P. The treatment of buckle fractures in a bandage: a prospective randomised trial [abstract]. Journal of Bone and Joint Surgery. British Volume 2004;86(Suppl III):286.
Williams 2013 {published data only}
    1. Williams K. A comparison of casting and splinting in pediatric radial buckle fractures. clinicaltrials.gov/ct2/show/NCT01010347 (first received 10 November 2009).
    1. Williams KG, Smith G, Luhmann SJ, Mao J, Gunn JD 3rd, Luhmann JD. A randomized controlled trial of cast versus splint for distal radial buckle fracture: An evaluation of satisfaction, convenience, and preference. Pediatric Emergency Care 2013;29(5):555‐9. - PubMed

References to studies excluded from this review

Abramo 2009 {published data only}
    1. Abramo A, Kopylov P, Geijer M, Tägil M. Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures: a randomized study of 50 patients. Acta Orthopaedica 2009;80(4):478‐85. [DOI: 10.3109/17453670903171875] - DOI - PMC - PubMed
Bae 2012 {published data only}
    1. Bae DS, Howard AW. Distal radius fractures: What is the evidence?. Journal of Pediatric Orthopaedics 2012;32:S128‐S130. - PubMed
Basdekis 2006 {published data only}
    1. Basdekis GK, Varitimidis S, Dailiana ZH, Hantes ME, Bargiotas K, Malizos KN. Intra‐articular distal radius fractures: fluoroscopic or arthroscopic reduction?. Journal of Bone and Joint Surgery. British Volume 2006;88‐B(SUPP I):187. - PubMed
Bhaskar 2000 {published data only}
    1. Bhaskar AR, Roberts JA. Treatment of unstable forearm fractures in children comparison of both bones versus single bone plating [abstract]. Journal of Bone and Joint Surgery. British Volume 2000;82 Suppl 1(CCT):63. - PubMed
Clarke 2007 {published data only}
    1. Bell M. EPOS Randomised controlled trial of management of distal radial fractures: A randomised controlled trial comparing Kirschner wire stabilisation versus manipulation and plaster. National Research Register 2007, issue 3.
    1. Bell M. Study status [personal communication]. Email to: H Handoll 4 September 2007.
    1. Clarke NM. EPOS Randomised controlled trial of management of distal radial fractures: A randomised controlled trial comparing Kirschner wire stabilisation versus manipulation and plaster. National Research Register 2002, issue 3.
    1. Clarke NM. Study status [personal communication]. Email to: H Handoll 10 September 2007.
Cohen 1997 {published data only}
    1. Cohen MS, Frillman T. Distal radius fractures: A prospective randomized comparison of fibreglass tape with QuickCast(TM). Injury 1997;28(4):305‐9. - PubMed
Colaris 2013b {published data only}
    1. Colaris JW, Reijman M, Allema JH, Biter LU, Bloem RM, Ven CP, et al. Early conversion to below‐elbow cast for non‐reduced diaphyseal both‐bone forearm fractures in children is safe: preliminary results of a multicentre randomised controlled trial. Archives of Orthopaedic and Trauma Surgery 2013;133(10):1407‐14. [DOI: 10.1007/s00402-013-1812-8] - DOI - PubMed
Delattre 1994 {published data only}
    1. Delattre O, Saillant G, Lemoine J, Benazet JP, Roy‐Camille R. Reduction and osteosynthesis with pin fixation of wrist fractures. A comparative study between Kapandji's and Py's techniques. Revue de Chirurgie Orthopedique et Reparatrice de l'appareil Moteur 1994;80(2):94‐107. [PMID: 7899635] - PubMed
Dresing 2009 {published data only}
    1. Dresing K, Schleikis A, Sturmer KM. Primary definitive cast therapy on the upper and lower extremities : IIndications and cost analysis. Der Chirurg; Zeitschrift fur alle Gebiete der Operativen Medizen 2009;80(3):223‐30. [DOI: 10.1007/s00104-008-1636-1] - DOI - PubMed
Duncan 2006 {published data only}
    1. Duncan RD. Pinning or plaster for the unstable wrist fracture in children?. National Research Register 2006.
Egol 2008 {published data only}
    1. Egol K, Walsh M, Tejwani N, McLaurin T, Wynn C, Paksima N. Bridging external fixation and supplementary Kirschner‐wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. Journal of Bone and Joint Surgery. British Volume 2008;90(9):1214‐21. [DOI: 10.1302/0301-620X.90B9.20521] - DOI - PubMed
Fikry 1998 {published data only}
    1. Fikry T, Fadili M, Harfoui A, Dkhissi M, Zryouil B. Metaphysis fracture of the distal radius: Kapandji's or Py's pinning? [Fractures metaphysaires du radius distal: embrochage de Kapandji ou de Py?]. Annales de Chirurgie de la Main et du Membre Superieur 1998;17(1):31‐40. [PMID: 10941382] - PubMed
Franke 2013 {published data only}
    1. Franke J, Vetter SY, Mühlhäuser I, Grützner PA, Recum J. Virtual implant planning system: first clinical results. Bone and Joint Journal 2013;95(SUPP 28):76.
Gradl 2014 {published data only}
    1. Gradl G, Mielsch N, Wendt M, Falk S, Mittlmeier T Gierer P, et al. Intramedullary nail versus volar plate fixation of extra‐articular distal radius fractures. Two year results of a prospective randomized trial. Injury 2014;45(Suppl 1):S3‐8. [DOI: 10.1016/j.injury.2013.10.045] - DOI - PubMed
Gupta 1991 {published data only}
    1. Gupta A. The treatment of Colles' fracture. Immobilisation with the wrist dorsiflexed. Journal of Bone and Joint Surgery. British Volume 1991;73(2):312‐5. [PMID: 2005163] - PubMed
Hahnloser 1999 {published data only}
    1. Hahnloser D, Platz A, Amgwerd M, Trentz O. Internal fixation of distal radius fractures with dorsal dislocation: pi‐plate or two 1/4 tube plates? A prospective randomized study. Journal of Trauma 1999;47(4):760‐5. [DOI: 10.1097/00005373-199910000-00024] - DOI - PubMed
Hargreaves 2004 {published data only}
    1. Hargreaves DG, Drew SJ, Eckersley R. Kirschner wire pin tract infection rates: a randomized controlled trial between percutaneous and buried wires. Journal of Hand Surgery 2004;29(4):374‐6. [DOI: 10.1016/j.jhsb.2004.03.003] - DOI - PubMed
Ho 2010 {published data only}
    1. Ho CA, Wilson PL. A comparison of fracture reductions performed by physician extenders and orthopaedic residents in the acute pediatric orthopaedic practice. Journal of Orthopaedic Trauma 2010;24(4):244‐9. [DOI: 10.1097/BOT.0b013e3181bd5863] - DOI - PubMed
Hutchinson 1995 {published data only}
    1. Hutchinson DT, Strenz GO, Cautilli RA. Pins and plaster vs external fixation in the treatment of unstable distal radial fractures. A randomized prospective study. Journal of Hand Surgery (Edinburgh, Scotland) 1995;20(3):365‐72. [PMID: 7561414] - PubMed
ISRCTN25187648 {published data only}
    1. Hudson A. Forearm buckle fracture treatment study. www.isrctn.com/ISRCTN25187648 (first received 30 September 2005).
    1. Hudson A. Study status [personal communication]. Email to: J Elliott 22 March 2017.
ISRCTN34857372 {published data only}
    1. Jacobs M. Distal forearm torus fractures ‐ do they need a splint?. apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN34857372 (first received 28 September 2007).
    1. Jacobs M. Study status [personal communication]. Email to: J Elliott 6 March 2017.
Kasapinova 2009 {published data only}
    1. Kasapinova K, Kamiloski V. Pain and disability during six months in patients with a distal radius fracture. Makedonska Akademija na Naukite i Umetnostite Oddelenie za Bioloshki i Meditsinski Nauki Prilozi 2009;30(2):185‐96. - PubMed
Kavouriadis 2012 {published data only}
    1. Kavouriadis V, O'Gorman A, Bain G, Ashwood N. Is external fixation a better way than plaster to supplement k‐wires in noncomminuted distal radius fractures? A prospective randomised surgeon independent study. Journal of Bone and Joint Surgery. British Volume 2012;94(SUPP III):135.
Khan 2007 {published data only}
    1. Khan KS, Grufferty A, Gallagher O, Moore DP, Fogarty E, Dowling F. A randomized trial of 'soft cast' for distal radius buckle fractures in children. Acta Orthopaedica Belgica 2007;73(5):594‐7. [PMID: 18019914] - PubMed
Krishnan 2003 {published data only}
    1. Krishnan J, Wigg AE, Walker RW, Slavotinek J. Intra‐articular fractures of the distal radius: a prospective randomised controlled trial comparing static bridging and dynamic non‐bridging external fixation. Journal of Hand Surgery 2003;28(5):417‐21. [DOI: 10.1016/S0266-7681(03)00083-4] - DOI - PubMed
Krishnan 2014 {published data only}
    1. Krishnan M, Jacob C. Splints are an overall better alternative to casting for torus fractures in children in rural hospitals. International Journal of Recent Trends in Science And Technology 2014;12(3):446‐8.
Lidstrom 1959 {published data only}
    1. Lidstrom A. Fractures of the distal end of the radius. A clinical and statistical study of end results. Acta Orthopaedica Scandinavica 1959;Supplementum 41:1‐118. - PubMed
Lu 2014 {published data only}
    1. Lu B, Liu P, Wang Y. Application of elastic intramedullary nail in the treatment of both ulna and radius fractures in children. Zhonghua Yi Xue Za Zhi 2014;94(24):1882‐5. - PubMed
McQueen 1996 {published data only}
    1. McQueen MM, Hajducka C, Court‐Brown CM. Redisplaced unstable fractures of the distal radius. Journal of Bone and Joint Surgery. British Volume 1996;78(3):404‐9. - PubMed
Mitsukane 2015 {published data only}
    1. Mitsukane M, Sekiya N, Himei S, Oyama K. Immediate effects of repetitive wrist extension on grip strength in patients with distal radial fracture. Archives of Physical Medicine and Rehabilitation 2015;96(5):862‐8. - PubMed
Mullett 2002 {published data only}
    1. Mullett H, O’Connor D, Doyle M, Kutty S, Laing A, O’Sullivan M. Plaster cast vs futura splint: a prospective randomised trial in the treatment of distal radial fractures. Journal of Bone and Joint Surgery. British Volume 2002;84(SUPP I):11.
Murphy 2010 {published data only}
    1. Murphy M, Flannery O, Kenny P, Keogh P, Lui D, Hugh G, et al. Outcome following buried versus exposed kirschner wiring of distal radius fractures: a randomised controlled trial. Journal of Bone and Joint Surgery. British Volume 2010;92((SUPP IV)):581‐2.
    1. Murphy M, Flannery O, McHugh G, Lui D, Kenny P, Keogh P, et al. Outcome following buried versus exposed kirschner wiring of distal radius fractures: a randomised controlled trial. Journal of Bone and Joint Surgery ‐ British Volume 2010;92(SUPP I):50‐1.
NCT00398268 {published data only}
    1. Colaris JW. Dislocated unstable distal both‐bone forearm fractures in children. clinicaltrials.gov/ct2/show/NCT00398268 (first received 10 November 2006).
NCT01493167 {published data only}
    1. Lindfors NC. Study on wood‐plastic composite for circumferential casting. clinicaltrials.gov/ct2/show/NCT01493167 (first received 15 December 2011).
    1. Pirhonen E. Study population and status [personal communication]. Email to: J Elliott 23 March 2017.
NCT01762605 {published data only}
    1. Gardner A. Treatment of distal radius buckle fractures. clinicaltrials.gov/ct2/show/NCT01762605 (first received 8 January 2013).
Parsch 2002 {published data only}
    1. Parsch K. Radius and ulna fractures in children. Journal of Bone and Joint Surgery. British Volume 2002;84(SUPP III):360‐1.
Pieske 2008 {published data only}
    1. Pieske O, Geleng P, Zaspel J, Piltz S. Titanium alloy pins versus stainless steel pins in external fixation at the wrist: a randomized prospective study. Journal of Trauma 2008;64(5):1275‐80. [DOI: ] - PubMed
Pieske 2011 {published data only}
    1. Pieske O, Pichlmaier L, Kaltenhauser F, Schramm N, Rubenbauer B Greiner A, et al. Hydroxyapatite‐coated pins versus titanium alloy pins in external fixation at the wrist: a controlled cohort study. Journal of Trauma 2011;70(4):845‐51. [DOI: ] - PubMed
Pritchett 1994 {published data only}
    1. Pritchett JW. Does pinning cause distal radial growth plate arrest?. Orthopedics 1994;17(6):550‐2. - PubMed
Robert 2011 {published data only}
    1. Robert CE, Jiang JJ, Khoury JG. A prospective study on the effectiveness of cotton versus waterproof cast padding in maintaining the reduction of pediatric distal forearm fractures. Journal of Paediatric Orthopaedics 2011;31(2):144‐9. [DOI: ] - PubMed
Saddiki 2011 {published data only}
    1. Saddiki R, Harisboure A, Hemery X, Ohl X, Kabbaj R, Dehoux É. Comparative studies of the py and Kapandji techniques for fractures of the distal radius with posterior displacement. Journal of Bone and Joint Surgery. British Volume 2011;93(SUPP IV):526.
Schønnemann 2011 {published data only}
    1. Schønnemann JO, Hansen TB, Søballe K. Randomised study of non‐bridging external fixation compared with intramedullary fixation of unstable distal radial fractures. Journal of Plastic Surgery and Hand Surgery 2011;45(4‐5):232‐7. - PubMed
Serrano‐Fernandez 2008 {published data only}
    1. Serrano‐Fernandez JM, Espejo‐Baena A, Martin‐Castilla B, Torre‐Solis F, Mariscal‐Lara J, Merino‐Ruiz ML. Bridging external fixation and supplementary Kirschner‐wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. Journal of Bone and Joint Surgery. British Volume 2008;90(9):1214‐21. - PubMed
Sha 2015 {published data only}
    1. Sha L, Chen Q, Sun L, Dong B, Li L. Effectiveness comparison of external fixation and volar locking compression plate in treatment of distal radius fractures of type c. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi [Chinese Journal of Reparative and Reconstructive Surgery] 2015;29(6):683‐7. - PubMed
Sutherland 2011 {published data only}
    1. Sutherland M. Casting vs. splinting for wrist fractures in children. American Family Physician 2011;83(9):83 (9) (no pagination).
Tamblyn 2010 {published data only}
    1. Tamblyn P, McCamley C, Kimber C, Jaarsma R. Volar locking plate for distal radius fractures: a prospective randomised controlled study. Journal of Bone and Joint Surgery. British Volume 2010;92(SUPP I):214.
Vang Hansen 1998 {published data only}
    1. Vang Hansen F, Staunstrup H, Mikkelsen S. A comparison of 3 and 5 weeks immobilization for older type 1 and 2 Colles' fractures. Journal of Hand Surgery 1998;23(3):400‐1. - PubMed
Van Manen 2008 {published data only}
    1. Manen CJ, Dekker ML, Eerten PV, Rhemrev SJ, Olden GD, Elst M. Bio‐resorbable versus metal implants in wrist fractures: a randomised trial. Archives of Orthopaedic and Trauma Surgery 2008;128(12):1413‐7. [DOI: ] - PubMed
Walker 2003 {published data only}
    1. Walker RW, Wigg A, Krishnan J, Slavotinek J. Intra‐articular fractures of the distal radius: a prospective randomised trial comparing bridging and non‐bridging external fixation. Journal of Bone and Joint Surgery. British Volume 2003;85(SUPP I):27‐8.
Witney‐Lagen 2013 {published data only}
    1. Witney‐Lagen C, Smith C, Walsh G. Soft cast versus rigid cast for treatment of distal radius buckle fractures in children. Injury 2013;44(4):508‐13. [DOI: ] - PubMed
Young 2003 {published data only}
    1. Young CF, Nanu AM, Checketts RG. Seven year outcome study of colles’ type distal radial fractures. Journal of Bone and Joint Surgery. British Volume 2003;85(SUPP I):27.
Yousef 2006 {published data only}
    1. Yousef A, Al‐Jafari N, Horton T. Soft cast verses plaster of Paris treatment of greenstick forearm fractures in children [abstract]. Journal of Bone and Joint Surgery. British Volume 2006;88(Suppl 2):278.
Zhao 2015 {published data only}
    1. Zhao C. Outcomes of different operations for distal forearm fractures in children. Chinese Medical Journal 2015;95(15):1168‐70. - PubMed

References to studies awaiting assessment

ACTRN12611000101987 {published data only}
    1. Huh K. Long arm casting versus splinting after manipulation of distal third radius fractures in children. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12611000101987 (first received 31 January 2011).
Bae 2015 {published data only}
    1. Bae D. Randomized trial of casting techniques for displaced forearm fractures. clinicaltrials.gov/ct2/show/NCT00823823?term=NCT00823823&rank=1 (first received 16 January 2009).
    1. Bae D. Study status [personal communication]. Email to: J Elliott 7 March 2017.
    1. Bae D S, Valim C, Connell P, Brustowicz KA, Waters PM. Bivalved versus circumferential cast immobilization for displaced forearm fractures: a randomized clinical trial to assess efficacy and safety. Journal of Pediatric Orthopedics 2017;37:239‐46. - PubMed
    1. Bae DS, Valim C, Connell P, Brustowicz K, Waters PM. Circumferential vs bivalved cast immobilization for displaced forearm fractures: A randomized clinical trial to assess safety and efficacy: Level 1 evidence (Abstract). Journal of Hand Surgery 2012;8 Suppl:41‐2.
Baldwin 2017 {published data only (unpublished sought but not used)}
    1. Baldwin PC 3rd, Han E, Parrino A, Solomito MJ, Lee MC. Valve or no valve: a prospective randomized controlled trial of casting options for pediatric forearm fractures. Orthopedics 2017;40:e849‐54. - PubMed
    1. Lee M, Solomito M. Is univalving or bivalving of long arm casts for forearm fractures necessary?. clinicaltrials.gov/ct2/show/NCT02614690 (first received 25 November 2015).
    1. Solomito M. Trial status [personal communication]. Email to: J Elliott 12 April 2017.
NCT02670629 {published data only}
    1. Hernandez A. Confirmation that the trial will be published shortly [personal communication]. Email to: J Elliott 8 March 2017.
    1. Lemus OF. Management of distal radius fractures in children younger than 11 years old. clinicaltrials.gov/ct2/show/NCT02670629 (first received 2 February 2016).
NCT03097757 {published data only}
    1. Rabiner J. Randomized controlled trial of ultrasound guidance for reduction of pediatric forearm fractures. clinicaltrials.gov/ct2/show/record/NCT03097757 (first received 31 March 2017).
NTR2508 {published data only}
    1. Brusse C. Paediatric distal radius torus fracture treatment comparison in a prospective randomized control trial: Mitella versus plaster cast. apps.who.int/trialsearch/Trial2.aspx?TrialID=NTR2508 (first received 6 September 2010).

References to ongoing studies

Adrian 2015 {published data only}
    1. Adrian M, Wachtlin D, Kronfeld K, Sommerfeldt D, Wessel LM. A comparison of intervention and conservative treatment for angulated fractures of the distal forearm in children (AFIC): study protocol for a randomized controlled trial. Trials 2015;16:437. [DOI: ] - PMC - PubMed
    1. Wessel LM. Angulated fractures of the distal forearm in children: is remodeling a therapeutic option?. apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00004874 (first received 30 October 2013).
FORCE 2018 {published data only}
    1. FORCE. www.ndorms.ox.ac.uk/clinical‐trials/current‐trials‐and‐studies/force (accessed 23 October 2018).
    1. Perry D. FORCE The FOrearm fracture Recovery in Children Evaluation. A multi‐centre prospective randomized equivalence trial of a soft bandage and immediate discharge versus current treatment with rigid immobilisation for torus fractures of the distal radius in children. Health Technology Assessment Research Projects www.journalslibrary.nihr.ac.uk/programmes/hta/172302/#/ (accessed 12 July 2018). - PMC - PubMed
NCT03248687 {published data only}
    1. Boutis K. Home management versus primary care physician follow up in children with distal radius fractures: A randomized control trial. clinicaltrials.gov/ct2/show/record/NCT03248687 (first received 14 August 2017).
NCT03297047 {published data only}
    1. Staubli G. Randomized controlled trial comparing forearm and upper arm combi cast for immobilization after closed reduced distal forearm fractures in children. clinicaltrials.gov/ct2/show/record/NCT03297047 (first received 29 September 2017).

Additional references

Abson 2016
    1. Abson S, Williams N, Inglis M, Antoniou G, Cundy P. Resident versus attending surgeons in achieving and maintaining fracture reduction in pediatric distal radius fractures. Journal of Pediatric Orthopaedics 2016;36(5):478‐82. - PubMed
Atrey 2010
    1. Atrey A, Nicolaou N, Katchburian M, Norman‐Taylor F. A review of reported litigation against English health trusts for the treatment of children in orthopaedics: present trends and suggestions to reduce mistakes. Journal of Children's Orthopaedics 2010;4(5):471‐6. - PMC - PubMed
Biag 2017
    1. Baig MN, Egan C. Improving management of paediatric buckle fracture in orthopaedic outpatients: A completed audit loop. Cureus 2017;8(9(11)):e1829. - PMC - PubMed
Bieri 1990
    1. Bieri D, Reeve RA, Champion GD, Addicoat L, Ziegler JB. The Faces Pain Scale for the self assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain 1990;41(2):139‐50. - PubMed
Bould 1999
    1. Bould M, Bannister GC. Refractures of the radius and ulna in children. Injury 1999;30(9):583‐6. - PubMed
Boutis 2014
    1. Boutis K, Howard A, Constantine E, Cuomo A, Narayanan U. Evidence into practice: emergency physician management of common pediatric fractures. Pediatric Emergency Care 2014;30(7):462‐8. - PubMed
Covidence
    1. Covidence systematic review software, Veritas Health Innovation, Melbourne, Australia. Available at www.covidence.org.
Crawford 2012
    1. Crawford SN, Lee LS, Izuka BH. Closed treatment of overriding distal radial fractures without reduction in children. Journal of Bone and Joint Surgery. American Volume 2012;94(3):246‐52. - PubMed
Daltroy 1998
    1. Daltroy LH, Liang MH, Fossel AH, Goldberg MJ, Pediatric Orthopaedic Society of North America. The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Pediatric Outcomes Instrument Development Group. Pediatric Orthopaedic Society of North America. Journal of Pediatric Orthopaedics 1998;18(5):561‐71. - PubMed
Deshpande 2014
    1. Despande MM, Nadkarni S. Disadvantages of the synthetic cast (letter). Bone and Joint Journal 2014:bjj.boneandjoint.org.uk/content/95‐B/9/1285.e‐letters.
Dua 2017
    1. Dua K, Stein MK, O'Hara NN, Brighton BK, Hennrikus WL, Herman MJ, et al. Variation among pediatric orthopaedic surgeons when diagnosing and treating pediatric and adolescent distal radius fractures. Journal of Pediatric Orthopedics 2017 Feb 27;[Epub ahead of print]:doi: 10.1097/BPO.0000000000000954. - PubMed
Egger 1997
    1. Egger M, Smith GD, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;317(7109):629‐34. - PMC - PubMed
GRADEpro GDT 2015 [Computer program]
    1. GRADE Working Group, McMaster University. GRADEpro GDT. Hamilton (ON): GRADE Working Group, McMaster University, 2015.
Hedström 2010
    1. Hedström EM, Svensson O, Bergström U, Michno P. Epidemiology of fractures in children and adolescents: increased incidence over the past decade: a population‐based study from northern Sweden. Acta Orthopaedica 2010;81(1):148‐53. - PMC - PubMed
Hendrickx 2011
    1. Hendrickx RP, Campo MM, Lieshout AP, Struijs PA, Bekerom MP. Above‐ or below‐elbow casts for distal third forearm fractures in children? A meta‐analysis of the literature. Archives of Orthopaedic and Trauma Surgery 2011;131(12):1663‐71. [DOI: 10.1007/s00402-011-1363-9] - DOI - PubMed
Hernandez 2018
    1. Hernandez A, Martinez A. Displaced distal radius fractures in children younger than 11 years old: a randomised controlled trial comparing two treatment methods. Orthopaedic Trauma Association Annual Meeting, 2018 October 17–20; Kissimmee (FL). 2018.
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hill 2016
    1. Hill CE, Masters JP, Perry DC. A systematic review of alternative splinting versus complete plaster casts for the management of childhood buckle fractures of the wrist. Journal of Pediatric Orthopaedics B 2016;25(2):183‐90. [DOI: 10.1097/BPB.0000000000000240] - DOI - PubMed
Howes 2008
    1. Howes MC, Cutting P, Thomas M. Splinting of buckle fractures of the distal radius in children. Emergency Medicine Journal 2008;25(4):222‐3. [DOI: 10.1136/emj.2008.058172] - DOI - PubMed
Hunter 2018
    1. Hunter J. Information on the proposed CRAFT trial [personal communication]. Email to: H Handoll 24 September 2018.
Jiang 2016
    1. Jiang N, Cao ZH, Ma YF, Lin Z, Yu B. Management of pediatric forearm torus fractures: a systematic review and meta‐analysis. Pediatric Emergency Care 2016;32(11):773‐8. - PubMed
Karl 2015
    1. Karl JW, Olson PR, Rosenwasser MP. The epidemiology of upper extremity fractures in the United States, 2009. Journal of Orthopaedic Trauma 2015;29(8):e242‐4. - PubMed
Kennedy 2010
    1. Kennedy SA, Slobogean GP, Mulpuri K. Does degree of immobilization influence refracture rate in the forearm buckle fracture?. Journal of Pediatric Orthopaedics Part B 2010;19(1):77‐81. - PubMed
Khandekar 2016
    1. Khandekar S, Tolessa E, Jones S. Displaced distal end radius fractures in children treated with Kirschner wires ‐ A systematic review. Acta Orthopaedica Belgica 2016;82(4):681‐9. - PubMed
Kumar 2006
    1. Kumar G. Comparison of short and long arm plaster casts for displaced fractures in the distal third of the forearm in children (letter). Journal of Bone and Joint Surgery. American Volume 2006;88(8):1888; author reply 1888‐9. - PubMed
Leclercq 2013
    1. Leclercq E, Leeflang MM, Dalen EC, Kremer LC. Validation of search filters for identifying pediatric studies in PubMed. Journal of Pediatrics 2013;162(3):629‐34. - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Li 2014
    1. Li X‐L, Li G‐H. Splint versus plaster cast external fixator for the treatment of distal forearm buckle fracture in children: Systematic review. Chinese Journal of Tissue Engineering Research 2014;18(13):2113‐8. [DOI: 10.3969/j.issn.2095-4344.2014.13.024] - DOI
Macnicol 2010
    1. Macnicol MF, Parsch K. Chapter 45: wrist and hand fractures. In: Benson M, Fixsen J, Macnicol M, Parsch K editor(s). Children's Orthopaedics and Fractures. London: Springer‐Verlag, 2010:743‐50.
Mehlman 2002
    1. Mehlman CT. Home removal of a backslab 3 weeks after buckle fracture of the distal radius was as safe as removal at a fracture clinic. Journal of Bone and Joint Surgery. American Volume 2002;84(5):883.
Mellstrand‐Navarro 2014
    1. Mellstrand‐Navarro C, Pettersson HJ, Tornqvist H, Ponzer S. The operative treatment of fractures of the distal radius is increasing: results from a nationwide Swedish study. Bone and Joint Journal 2014;96(7):963‐9. - PubMed
Mizuta 1987
    1. Mizuta T, Benson WM, Foster BK, Paterson DC, Morris LL. Statistical analysis of the incidence of physeal fractures. Journal of Pediatric Orthopedics 1987;7(5):518‐23. - PubMed
Morris 2006
    1. Morris MW, Bell MJ. The socio‐economical impact of paediatric fracture clinic appointments. Injury 2006;37(5):395‐7. - PubMed
NICE 2016
    1. National Institute for Health and Care Excellence. Fractures (non‐complex): assessment and management. NICE guidelines [NG38], 2016. www.nice.org.uk/guidance/ng38/evidence/full‐guideline‐2358460765 (accessed 19 May 2016).
Proctor 1993
    1. Proctor MT, Moore DJ, Paterson JM. Redisplacement after manipulation of distal radial fractures in children. Journal of Bone and Joint Surgery. British Volume 1993;75(3):453‐4. - PubMed
Randsborg 2009
    1. Randsborg PH, Sivertsen EA. Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures. Acta Orthopaedica 2009;80(5):585‐9. - PMC - PubMed
Randsborg 2012
    1. Randsborg PH, Sivertsen EA. Classification of distal radius fractures in children: good inter‐ and intraobserver reliability, which improves with clinical experience. BMC Musculoskeletal Disorders 2012;13:6. [DOI: 10.1186/1471-2474-13-6] - DOI - PMC - PubMed
Rennie 2007
    1. Rennie L, Court‐Brown CM, Mok JY, Beattie TF. The epidemiology of fractures in children. Injury 2007;38(8):913‐22. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Salter 1963
    1. Salter RB, Harris WR. Injuries involving the epiphyseal plate. Journal of Bone and Joint Surgery. American Volume 1963;45(3):587‐622.
Schneidmüller 2011
    1. Schneidmüller D, Röder C, Kraus R, Marzi I, Kaiser M, Dietrich D, et al. Development and validation of a paediatric long‐bone fracture classification. A prospective multicentre study in 13 European paediatric trauma centres. BMC Musculoskeletal Disorders 2011;12:89. [DOI: 10.1186/1471-2474-12-89] - DOI - PMC - PubMed
Schünemann 2011
    1. Schünemann HJ, Oxman AD, Higgins JPT, Vist GE, Glasziou P, Guyatt GH. Chapter 11: Presenting results and 'Summary of findings' tables. In: Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Shah 2015
    1. Shah NS, Buzas D, Zinberg EM. Epidemiologic dynamics contributing to pediatric wrist fractures in the United States. Hand 2015;10(2):266‐71. - PMC - PubMed
Slongo 2007
    1. Slongo T, Audigé L, AO Pediatric Classification Group. Fracture and dislocation classification compendium for children: the AO pediatric comprehensive classification of long bone fractures (PCCF). Journal of Orthopaedic Trauma 2007;21 Suppl 10:135‐60. - PubMed
Thimmaiah 2012
    1. Thimmaiah R, Bass A. Paediatric fracture clinic referrals: what does it consist of?. British Journal of Medical Practitioners 2012;5(2):a521.
Von Keyserlingk 2011
    1. Keyserlingk C, Boutis K, Willan AR, Hopkins RB, Goeree R. Cost‐effectiveness analysis of cast versus splint in children with acceptably angulated wrist fractures. International Journal of Technology Assessment in Health Care 2011;27(2):101‐7. - PubMed
Wierzimok 2017
    1. Wierzimok AA. Conservative plaster‐free fracture treatment with definitive cast bandage / MOKcast. www.mokcast.com/index_e.html (accessed 20 April 2017).
Wilkins 2005
    1. Wilkins KE. Principles of fracture remodelling in children. Injury 2005;36 Suppl 1:A3‐11. - PubMed
Williams 2005
    1. Williams AA, Szabo RM. Case report: radial overgrowth and deformity after metaphyseal fracture fixation in a child. Clinical Orthopaedics and Related Research 2005;(435):258‐62. - PubMed
Young 2000
    1. Young NL, Wiliams JI, Joshida KK, Wright JG. Measurement properties of the Activities Scale for Kids. Journal of Clinical Epidemiology 2000;53(2):125‐37. - PubMed

References to other published versions of this review

Abraham 2008
    1. Abraham A, Handoll HH, Khan T. Interventions for treating wrist fractures in children. Cochrane Database of Systematic Reviews 2008, Issue 2. [DOI: 10.1002/14651858.CD004576.pub2] - DOI - PubMed
Handoll 2016
    1. Handoll HH, Elliott J, Iheozor‐Ejiofor Z, Hunter J, Karantana A. Interventions for treating wrist fractures in children. Cochrane Database of Systematic Reviews 2016, Issue 12. [DOI: 10.1002/14651858.CD012470] - DOI - PMC - PubMed

Publication types