Abstract
Purpose
To determine, in skeletally immature children with acceptably angulated (< = 15 degrees deformity at presentation) distal radius fractures, if a pre-fabricated wrist splint is at least as effective as a cast.
Methods
A randomised controlled, non-inferiority, single blinded, single-centre trial was performed. The primary outcome was physical function at six weeks. Secondary outcomes included angulation, wrist range of motion, strength, pain, and patient preferences.
Results
93 of 97 randomised patients completed full follow-up. ASK scores at six weeks were 92.8 in the splint group and 91.4 in the cast group. Among patients treated in a cast, the average angular deformity at follow-up was 11.0 degrees, compared with an average of 6.6 degrees angulation among patients treated in a splint (p=0.02, t-test). Complications did not differ between groups, nor did range of motion.
Conclusion
Splinting was not inferior to casting, and in fact may be superior to casting, for maintaining the position of a minimally displaced distal radial metaphyseal fracture.
Significance
The benefits of splinting over casting have been previously established for undisplaced distal radius and ulnar fractures (Plint), this is the first study which extends the benefits of splinting to the large group of children with minimally displaced distal radius fractures
