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Randomized Controlled Trial
. 2023 Jul;26(4):217-222.
doi: 10.1016/j.cjtee.2023.04.001. Epub 2023 Apr 5.

Robert Jones bandage versus cast in the treatment of distal radius fracture in children: A randomized controlled trial

Jagar Doski  1 , Ramzy Shaikhan  2
Affiliations
Randomized Controlled Trial

Robert Jones bandage versus cast in the treatment of distal radius fracture in children: A randomized controlled trial

Jagar Doski et al. Chin J Traumatol. 2023 Jul.

Abstract

Purpose: The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones (RJ) bandage. The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence, child comfortability, and family satisfaction.

Methods: The study was a randomized controlled non-inferiority clinical trial including children with recent (less than 5 days) fractures at the distal end of the radius OTA/AO 23-A2, which is usually treated conservatively. Those with open fractures, pathological fracture, severely displaced fracture that needs reduction or multiple injuries were excluded. The participants were divided randomly into 2 groups according to the treatment modalities. Group 1 was treated by plaster of Paris cast (the control group), and Group 2 by modified RJ bandage (the trial group). The difference between the 2 groups was found by the Chi-squared test. The difference was considered statistically significant when the p value was less than 0.05.

Results: There were 150 children (aged 2 - 12 years, any gender) included in the study, 75 in each group. The complications occured in 5 (3.3%) cases only, pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2. There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment (p = 0.649). Children treated by RJ bandages were more comfortable than those treated by the cast (97.3% vs. 73.3%, p < 0.001) with a statistically significant difference between them. Contrary to that, the families were more satisfied with the cast than RJ bandage (88.0% vs. 81.3%), but without a statistically significant difference (p = 0.257).

Conclusion: RJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.

Keywords: Children; Distal end of radius; Fracture; Robert Jones bandage.

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Figures

Fig. 1
Fig. 1
A patient was treated by a cast.
Fig. 2
Fig. 2
Items used for Robert Jones bandage.
Fig. 3
Fig. 3
A patient was treated by Robert Jones bandage.
Fig. 4
Fig. 4
Radiographic film of a patient with a buckle fracture at the distal metaphysis of the radial bone.
Fig. 5
Fig. 5
Radiographic film of a patient with a metaphyseal fracture at the distal end of the radius.
Fig. 6
Fig. 6
Radiographic film of a patient with a fracture at the distal physis (Salter-Harris type 1) of the radial bone.
See this image and copyright information in PMC

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