Department of Surgery, College of Medicine, University of Duhok, Duhok, Iraq.
Orthopedics Department, Duhok Emergency Teaching Hospital, Duhok, Iraq.
Chin J Traumatol. 2023 Jul;26(4):217-222. doi: 10.1016/j.cjtee.2023.04.001. Epub 2023 Apr 5.
The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones (RJ) bandage. The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence, child comfortability, and family satisfaction.
The study was a randomized controlled non-inferiority clinical trial including children with recent (less than 5 days) fractures at the distal end of the radius OTA/AO 23-A2, which is usually treated conservatively. Those with open fractures, pathological fracture, severely displaced fracture that needs reduction or multiple injuries were excluded. The participants were divided randomly into 2 groups according to the treatment modalities. Group 1 was treated by plaster of Paris cast (the control group), and Group 2 by modified RJ bandage (the trial group). The difference between the 2 groups was found by the Chi-squared test. The difference was considered statistically significant when the p value was less than 0.05.
There were 150 children (aged 2 - 12 years, any gender) included in the study, 75 in each group. The complications occured in 5 (3.3%) cases only, pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2. There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment (p = 0.649). Children treated by RJ bandages were more comfortable than those treated by the cast (97.3% vs. 73.3%, p < 0.001) with a statistically significant difference between them. Contrary to that, the families were more satisfied with the cast than RJ bandage (88.0% vs. 81.3%), but without a statistically significant difference (p = 0.257).
RJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.
本研究旨在使用罗伯特·琼斯（Robert Jones，RJ）绷带治疗儿童桡骨远端骨折。目的是比较这种治疗方式与石膏固定在并发症发生率、患儿舒适度和家庭满意度方面的差异。
这是一项随机对照非劣效性临床试验，纳入了 OTA/AO 23-A2 型桡骨远端最近（<5 天）骨折的儿童患者，这些骨折通常采用保守治疗。排除开放性骨折、病理性骨折、需要复位的严重移位骨折以及多发伤的患者。根据治疗方式将患者随机分为两组，组 1 采用石膏固定（对照组），组 2 采用改良 RJ 绷带（试验组）。采用卡方检验比较两组之间的差异。当 p 值<0.05 时，差异被认为具有统计学意义。
共有 150 名（年龄 2-12 岁，任何性别）患儿纳入研究，每组 75 名。仅 5 例（3.3%）发生并发症，组 1 有 3 例压疮，组 2 有 2 例骨折移位。两种治疗方式的并发症发生率无统计学差异（p=0.649）。使用 RJ 绷带治疗的患儿舒适度明显优于使用石膏固定的患儿（97.3% vs. 73.3%，p<0.001），差异具有统计学意义。相反，家属对石膏固定的满意度高于 RJ 绷带（88.0% vs. 81.3%），但差异无统计学意义（p=0.257）。
在儿童桡骨远端可保守治疗的骨折中，RJ 绷带是石膏固定的一种非劣效替代方法。
