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Splinting versus casting of “torus” fractures to the distal radius in the paediatric patient presenting at the emergency department (ED): a literature review

Splinting versus casting of “torus” fractures to the distal radius in the paediatric patient presenting at the emergency department (ED): a literature review
Splinting versus casting of “torus” fractures to the distal radius in the paediatric patient presenting at the emergency department (ED): a literature review
AIM:To compare outcomes regarding splinting versus casting of paediatric torus fractures in the ED with the aim of establishing the preferred treatment.
METHODS:
Evidence was collated using electronic databases; Pubmed, Ovid, Medline and Cochrane library. Search terms included [torus fractures; buckle fractures; splinting distal radius fractures; paediatric wrist fractures; paediatric forearm fractures/injuries; cast versus splint]. Searches identified papers published between 1984 and June 2008.
RESULTS:
The review demonstrated that children with removable splints preferred them to casts, in terms of improved physical functioning and lower pain scores reported after initial injury than those with casts. Children demonstrated this by using their wrists in the first week after injury to shower and bathe more easily. The cast group reported unscheduled visits to ED due to problems with the cast, such as discomfort or re-application of the cast from getting it wet. Using a splint will have considerable economic implications, money was found to be saved in terms of time and resource management. Radiographs taken at 4 weeks in both the cast and splint group confirmed that all fractures healed without significant change in alignment, suggesting that neither clinical nor radiographic follow-up is necessary for injury.
CONCLUSION:
Torus splints in all the studies were consistently better than plaster immobilisation in terms of clinical outcome, patient preference and cost, with the exceptions of young children or children with special needs who can easily remove the device. Splinting torus fractures may reduce cost, time and resource management if used instead of casting in the ED.
torus fracture, buckle fracture, distal radius fractures, splinting, casting
1755-599X
173-178
Firmin, Fiona
7889cfe2-dc98-4917-a0a0-81aba4082757
Crouch, Robert
7f98a42e-ee34-4520-ab33-83cd3acf05b7
Firmin, Fiona
7889cfe2-dc98-4917-a0a0-81aba4082757
Crouch, Robert
7f98a42e-ee34-4520-ab33-83cd3acf05b7

Firmin, Fiona and Crouch, Robert (2009) Splinting versus casting of “torus” fractures to the distal radius in the paediatric patient presenting at the emergency department (ED): a literature review. International Emergency Nursing, 17 (3), 173-178. (doi:10.1016/j.ienj.2009.03.006).

Record type: Article

Abstract

AIM:To compare outcomes regarding splinting versus casting of paediatric torus fractures in the ED with the aim of establishing the preferred treatment.
METHODS:
Evidence was collated using electronic databases; Pubmed, Ovid, Medline and Cochrane library. Search terms included [torus fractures; buckle fractures; splinting distal radius fractures; paediatric wrist fractures; paediatric forearm fractures/injuries; cast versus splint]. Searches identified papers published between 1984 and June 2008.
RESULTS:
The review demonstrated that children with removable splints preferred them to casts, in terms of improved physical functioning and lower pain scores reported after initial injury than those with casts. Children demonstrated this by using their wrists in the first week after injury to shower and bathe more easily. The cast group reported unscheduled visits to ED due to problems with the cast, such as discomfort or re-application of the cast from getting it wet. Using a splint will have considerable economic implications, money was found to be saved in terms of time and resource management. Radiographs taken at 4 weeks in both the cast and splint group confirmed that all fractures healed without significant change in alignment, suggesting that neither clinical nor radiographic follow-up is necessary for injury.
CONCLUSION:
Torus splints in all the studies were consistently better than plaster immobilisation in terms of clinical outcome, patient preference and cost, with the exceptions of young children or children with special needs who can easily remove the device. Splinting torus fractures may reduce cost, time and resource management if used instead of casting in the ED.

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More information

e-pub ahead of print date: May 2009
Published date: July 2009
Keywords: torus fracture, buckle fracture, distal radius fractures, splinting, casting
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 366246
URI: http://eprints.soton.ac.uk/id/eprint/366246
ISSN: 1755-599X
PURE UUID: d02b3d3b-077a-4aeb-9404-11826f5c2693

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Date deposited: 30 Jun 2014 10:26
Last modified: 14 Mar 2024 17:05

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Author: Fiona Firmin
Author: Robert Crouch

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