Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT02614690 |
Other study ID # |
SRC118 |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
January 2013 |
Est. completion date |
December 2015 |
Study information
Verified date |
January 2022 |
Source |
Connecticut Children's Medical Center |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
This study aims to examine the need for univalve or bivalve splitting of casts in pediatric
patients with forearm fractures following closed reduction and cast application in a
randomized, prospective fashion.
Description:
Following cast application, little is known regarding the need to split the cast, either in a
univalve (a split along a single side of the cast) or bivalve (a split along both sides of
the cast) fashion. Theoretically, the splitting of the cast allows for expansion and soft
tissue swelling. However, review of the literature yields a paucity of evidence demonstrating
the efficacy of splitting a cast. In a study by Nietosvaara et. al, a retrospective
examination of 109 pediatric patients initially treated with closed cylindrical casting for
closed forearm fractures were evaluated. Of these 109 patients, one-sixth required the
initial cast to be split, trimmed, or removed secondary to post-traumatic swelling.
However, the splitting of a cast is not without risks in itself. Once the initial swelling
dissipates, a univalved or bivalved cast can become excessively loose. This loosening has
been associated with a loss of reduction. If the loss or reduction is substantial, it may
require a re-reduction or operation to correct. In addition, with every use of the cast saw a
patient is placed at risk for iatrogenic cast saw injury. Thermal burns and abrasions from
cast saws can cause lifelong emotional and physical scars for a patient. They can also be an
inciting event for litigation against the hospital and or provider, with settlements
averaging greater than $12,000 per centimeter of cast saw injury.