Parents, Children Prefer Splints to Casts, and Research Shows They Are Effective
Munz, Michele, St Louis Post-Dispatch (MO)
Casts for broken bones can be heavy and cumbersome, especially for toddlers. And especially during the hot, summer months when the plaster makes it extra steamy and gets in the way of swimming.
Parents are happy to hear that mounting evidence shows a removable splint is just as effective as a cast when treating one of the most common pediatric injuries a buckle fracture near the wrist.
Buckle fractures typically occur when children fall and try to catch themselves with an outstretched hand. With all the running, jumping and tumbling that kids do, it's not surprising forearm fractures account for 50 percent of all childhood fractures.
Because children's bones are less dense than adult bones, most of these fractures are "buckle fractures," where the bone in the forearm bends instead of breaking all the way through.
New research published by Washington University School of Medicine shows that splints are clearly preferred by patients and their parents throughout their treatment in terms of convenience, satisfaction and pain.
The new findings, along with earlier studies showing equal effectiveness with splints and casts, has led to a recent change in the standard of treatment for such fractures at St. Louis Children's Hospital. Other area children's hospitals Cardinal Glennon Children's Medical Center and Mercy Children's St. Louis are also overwhelmingly opting for splints instead of casts.
Buckle fractures have traditionally been treated with a cast worn for three to four weeks.
"Often we do things because that's the way we've always done them, but maybe there's a better way to do this," said Dr. Kristine Williams, an assistant professor of pediatrics at Washington University who led the latest study. "It's really a question whether a cast for that length of time is really over-treatment."
Williams' study took place from April 2006 to May 2009 and involved 94 patients, ages 2 to 17, treated at St. Louis Children's Hospital's emergency department. The patients were randomly assigned to treatment with a below-the-elbow cast or prefabricated wrist splints. They or their parents were interviewed in the emergency department and again at days one, three, seven and 21 after the injury. …