The treatment of stable paediatric forearm fractures using a cast that may be removed at home

Comparison with traditional management in a randomised controlled trial

T. W. Hamilton, L. Hutchings, J. Alsousou, E. Tutton, E. Hodson, C. H. Smith, J. Wakefield, B. Gray, S. Symonds, K. Willett

Abstract

We investigated whether, in the management of stable paediatric fractures of the forearm, flexible casts that can be removed at home are as clinically effective, cost-effective and acceptable to both patient and parent as management using a cast conventionally removed in hospital. A single-centre randomised controlled trial was performed on 317 children with a mean age of 9.3 years (2 to 16). No significant differences were seen in the change in Childhood Health Assessment Questionnaire index score (p = 0.10) or EuroQol 5-Dimensions domain scores between the two groups one week after removal of the cast or the absolute scores at six months. There was a significantly lower overall median treatment cost in the group whose casts were removed at home (£150.88 (sem 1.90) vs £251.62 (sem 2.68); p < 0.001). No difference was seen in satisfaction between the two groups (p = 0.48).

Cite this article: Bone Joint J 2013;95-B:1714–20.

Footnotes

  • No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

    This article was primary edited by J. Scott and first-proof edited by D. Rowley.

  • Received November 16, 2012.
  • Accepted August 27, 2013.
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