Distal Radius Fractures Clinical Trial
Official title:
Cast Versus Splint in Children With Minimally Angulated Fractures of the Distal Radius: a Randomized Controlled Trial.
The study will compare the effectiveness of a prefabricated wrist splint with thermoplast
reinforcements versus a short arm cast in skeletally immature children.
The hypothesis is that the commercially available wrist splint is at least as effective as
traditional casting with respect to recovery of physical function.
Acceptability angulated wrist bone fractures in children carry an excellent long-term
prognosis because of the unique capacity of skeletally immature bones to heal via remodeling.
Their management varies widely and there is virtually no scientific evidence supporting one
treatment modality over another. Importantly, the most common treatment modality of cast
application for four to six weeks is associated with many inconveniences. There are
commercially available wrist splints that offer a more convenient alternative. Wrist splints
likely have comparable immobilization and symptom relief, while simultaneously allowing for
easier bathing and less reliance on subspeciality care. Preliminary adult evidence suggests
that, in a comparable adult fracture, splinting may offer a safe alternative to casting, with
earlier resumption of the usual activities. However, this treatment modality needs to be
compared to the traditional casting management in the pediatric population before it can be
recommended for clinical practice.
This study will be the first to challenge the current practice of routine casting and compare
it to a commercially available wrist splint with respect to recovery of physical function in
children with acceptably angulated wrist fractures. In addition, standardized treatment of
these fractures with a splint may be associated with lower morbidity, reduced use of health
care resources, and have the potential for cost savings.
This study will compare, in skeletally immature children, the functional outcomes that result
from treatment with a prefabricated wrist splint versus a short arm cast in acceptably
angulated distal radius fractures. Secondly, the cost-effectiveness of the splint relative to
the cast will be evaluated.
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