Orthopedics. 2021 Mar-Apr;44(2):e178-e182. doi: 10.3928/01477447-20201119-06. Epub 2020 Nov 25.
Displaced pediatric forearm fractures often are treated with closed reduction and immobilization. Recent literature demonstrates no difference in maintaining alignment or needing repeat intervention in patients immobilized with either a single sugar-tong splint or a long-arm cast, but most series include patients with distal fractures. This study included patients 3 to 15 years old who underwent closed reduction and immobilization for displaced midshaft or proximal forearm fractures. Radiographs from the time of injury, after reduction, and at 4-week follow-up were reviewed for coronal and sagittal plane angular alignment. Secondary interventions also were recorded. A total of 121 patients (70 long-arm cast, 51 simple sugar-tong splint) met inclusion criteria. Groups were matched in terms of age (=.95), sex (=.41), body mass index (=.12), and angular deformity prior to reduction in the sagittal (=.78) and coronal (=.83) planes. Following closed reduction, sagittal (=.003) and coronal (=.002) alignment improved significantly in all patients. At 4-week follow-up, there were no significant differences in sagittal (=.15) or coronal (=.68) alignment between the 2 groups. Nine patients underwent a secondary intervention after the index reduction (long-arm cast, n=7; simple sugar-tong splint, n=2), with no statistically significant difference between groups (=.30). There were no statistically significant differences between patients managed with long-arm cast or simple sugar-tong splint regarding residual sagittal or coronal plane deformity at 4-week follow-up or incidence of secondary intervention. These findings indicate simple sugar-tong splint and long-arm cast appear to be acceptable and equivalent methods of immobilization for these injuries. [. 2021;44(2):e178-e182.].
儿童前臂移位骨折常采用闭合复位和固定治疗。近期文献表明,无论是使用单糖 tong 夹板还是长臂石膏固定,在维持对线或需要重复干预方面,患者的效果没有差异,但大多数系列都包括远端骨折患者。本研究纳入了接受闭合复位和固定治疗的 3 至 15 岁儿童的中段或近段前臂移位骨折患者。对受伤时、复位后和 4 周随访时的 X 线片进行冠状面和矢状面角度对线评估。还记录了二次干预措施。共有 121 名患者(70 名长臂石膏固定,51 名简单糖 tong 夹板)符合纳入标准。两组在年龄(=0.95)、性别(=0.41)、体重指数(=0.12)和矢状面(=0.78)和冠状面(=0.83)复位前的角度畸形方面匹配。闭合复位后,所有患者的矢状面(=0.003)和冠状面(=0.002)对线均显著改善。4 周随访时,两组在矢状面(=0.15)或冠状面(=0.68)对线方面无显著差异。9 名患者在指数复位后进行了二次干预(长臂石膏固定,n=7;简单糖 tong 夹板,n=2),两组之间无统计学差异(=0.30)。在 4 周随访时,无论是使用长臂石膏固定还是简单糖 tong 夹板,患者的残余矢状面或冠状面畸形或二次干预发生率均无统计学差异。这些发现表明,对于这些损伤,简单糖 tong 夹板和长臂石膏固定似乎是可以接受的等效固定方法。[2021;44(2):e178-e182.]。