Women's and Children's Hospital, Department of Orthopaedic Surgery, King William Rd, North Adelaide 5000, Australia.
Bone Joint J. 2013 Sep;95-B(9):1285-9. doi: 10.1302/0301-620X.95B9.30666.
Fractures of the forearm (radius or ulna or both) in children have traditionally been immobilised in plaster of Paris (POP) but synthetic cast materials are becoming more popular. There have been no randomised studies comparing the efficacy of these two materials. The aim of this study was to investigate which cast material is superior for the management of these fractures. We undertook a single-centre prospective randomised trial involving 199 patients with acute fractures of the forearm requiring general anaesthesia for reduction. Patients were randomised by sealed envelope into either a POP or synthetic group and then underwent routine closed reduction and immobilisation in a cast. The patients were reviewed at one and six weeks. A satisfaction questionnaire was completed following the removal of the cast. All clinical complications were recorded and the cast indices were calculated. There was an increase in complications in the POP group. These complications included soft areas of POP requiring revision and loss of reduction with some requiring re-manipulation. There was an increased mean padding index in the fractures that lost reduction. Synthetic casts were preferred by the patients. This study indicates that the clinical outcomes and patient satisfaction are superior using synthetic casts with no reduction in safety.
前臂（桡骨或尺骨或两者）骨折在儿童中传统上采用石膏固定（POP），但合成石膏材料越来越受欢迎。目前还没有比较这两种材料疗效的随机研究。本研究旨在探讨哪种石膏材料更适合管理这些骨折。我们进行了一项单中心前瞻性随机试验，涉及 199 名需要全身麻醉复位的急性前臂骨折患者。患者通过密封信封随机分为 POP 组或合成组，然后接受常规闭合复位和石膏固定。患者在 1 周和 6 周时进行复查。拆除石膏后完成满意度调查问卷。记录所有临床并发症，并计算石膏指数。POP 组并发症增加。这些并发症包括需要修改的 POP 软区和部分需要重新复位的复位丢失。复位丢失的骨折平均填充指数增加。患者更喜欢合成石膏。本研究表明，使用合成石膏的临床结果和患者满意度更好，且安全性没有降低。
