Prospective Evaluation of Cast Bivalving for Pediatric Distal Radius Fractures

Brooke Army Medical Center

Status

Active, not recruiting

Conditions

Distal Radius Fracture

Loss of Anatomical Alignment After Fracture Reduction

Treatments

Radiation: Forearm anteroposterior and lateral plain radiograph

Study type

Observational

Funder types

Other U.S. Federal agency

Identifiers

NCT05716438

2019.008

Details and patient eligibility

About

Pediatric patients with distal radius fractures are most commonly treated non-operatively with fracture reduction and cast immobilization. In order to prevent complications from increased swelling after the injury (or fracture manipulation) casts may be split along their length to relieve pressure. However, this can compromise the casts' structural integrity, predisposing fractures to loss of reduction. The goal of this study was to investigate if cast bivalving, or splitting the cast longitudinally on both sides, resulted in any immediate change to bony alignment and to assess if bivalving effected cast parameters associated with loss of reduction.

Full description

Displaced pediatric distal radius fractures are treated with fracture reduction and cast immobilization. Currently, at our institution (and many others) radiographic assessment to determine acceptable fracture alignment and cast parameters is done immediately after cast application. However, afterward casts are often split on both sides along their length, in a process known as bivalving, prophylactically treating for post-traumatic soft tissue edema. While bivalving is felt to relieve pressure from the cast, it may also diminish the structural integrity of the cast. Although it is well-established that loss of fracture alignment is most common in the first few weeks after fracture reduction there have been no studies to evaluate any immediate changes to fracture reduction or cast parameters that may occur after bivalving. Thus, the goal of this study was to assess if pediatric distal radius fracture alignment was affected by cast bivalving by obtaining post-bivalve radiographs in addition to standard post-cast radiographs.

Enrollment

60 patients

Sex

All

Ages

1 to 17 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria