Purpose: Waterproof casts have been shown to be a safe and effective means of immobilization in children with minimally displaced fractures. The purpose of this study was to determine if waterproof Gore-Tex-lined casts are as effective as traditional cotton-lined casts in the immediate postoperative period after closed reduction of displaced distal radius fractures in children.

Method: We performed a retrospective review of distal radius fractures that underwent closed reduction and application of a long-arm cast between June 2004 and December 2006. A total of 124 cases were included (55 Gore-Tex; 69 traditional cotton-lined). The primary outcome measure was redisplacement in the cast. The cast index was also used to assess the quality of cast molding. Data was analyzed using repeated measures ANOVA. Power analyses were also conducted.

Results: There were no significant differences between the two groups with regards to translation of the radius or angulation of the radius on anterior-posterior (AP) and lateral radiographs at the time of injury, postreduction, or cast removal. Redisplacement as measured by the change in translation of the radius and angulation of the radius on AP and lateral radiographs from the time of reduction to cast removal was also not significantly different between the two groups. The mean cast index for the Gore-Tex and traditional cotton-lined groups was 0.882 and 0.873 respectively, which was not a significant difference.

Conclusion: A waterproof Gore-Tex-lined cast will maintain fracture reduction as well as a cotton-lined cast for closed reductions of distal radius fractures in children in the immediate postreduction period. Waterproof casts also provide extensive benefits to the patient with regards to bathing, hygiene, and participation in aquatic activities

We have developed a teaching programme for non-radiologists who use fluoroscopy, which includes techniques for reducing the radiation received by the patient and the surgeon during orthopaedic procedures. The techniques resolve around the radiation protection concepts of time, distance and shielding. The programme has been very successful in reducing the total fluoroscopy times of orthopaedic surgeons; in our institute, durations have been reduced to about 10% of those before the training started. We review the aims and content of our programme.