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Clinical and radiographic comparison of single-sugar-tong splint to long-arm cast immobilization for pediatric forearm fractures

Murphy, Robert F.; Plumblee, Leah; Sleasman, Brian; Barfield, William; Dow, Matthew A.; Mooney, James F. III

Journal of Pediatric Orthopaedics B: November 2019 - Volume 28 - Issue 6 - p 549–552
doi: 10.1097/BPB.0000000000000572
Trauma
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The purpose of this study was to compare the efficacy of a single-sugar-tong splint (SSTS) to a long-arm cast (LAC) in maintaining reduction of pediatric forearm fractures, while avoiding secondary intervention. One hundred patients age 3–15 with a forearm fracture requiring a reduction and immobilization were evaluated (50 LAC and 50 SSTS). Medical records and radiographs were reviewed at injury, postreduction, and at 1, 2, and 4 weeks postinjury. Sagittal and coronal angular deformities were recorded. Any secondary intervention due to loss of reduction was documented. The groups were matched by age (P = 0.19), sex (P = 0.26), mechanism of injury (P = 0.66), average injury sagittal deformity (LAC 27.4°, SSTS 25.4°; P = 0.50), and average injury coronal deformity (LAC 15.5°, SSTS 16°; P = 0.80) At 4 weeks postinjury follow-up, there were no statistically significant differences between use of an SSTS or LAC when comparing postimmobilization sagittal alignment (LAC 10.3 ± 7.2, SSTS 8.4 ± 5.1°; P = 0.46), coronal alignment (LAC 6.9 ± 4.6, SSTS 7.6 ± 9.3°; P = 0.46), or need for repeat manipulation or surgery (LAC 4/50, SSTS 3/50; P = 0.70).

Department of Orthopaedics, The Medical University of South Carolina, Charleston, South Carolina, USA

Correspondence to Robert F. Murphy, MD, Department of Orthopaedics, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 708, MSC 622, Charleston, SC 29492, USA Tel: + 1 843 792 8765; fax: + 1 843 792 3149; e-mail: murphyr@musc.edu

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