OBJECTIVE: The management and the diagnostic modalities used in cases of undisplaced greenstick and torus fractures of the distal radius in children vary between different treatment centres. The aim of this study was twofold: firstly, to analyse the sensitivity of X-rays versus ultrasound to diagnose these fractures; secondly, to compare three available treatment options (plaster cast, Futuro splints, and double Tubigrip) in terms of pain, analgesia requirements, grip strength, deformity, stiffness and interference with a child's activities of daily living. METHODS: We prospectively included 79 patients suffering from undisplaced greenstick and torus fractures of the distal radius. Patients were randomized (single blindly) to the studied treatment groups. RESULTS: In terms of diagnosis, the ultrasound was found to be more sensitive than X-rays for diagnosing these fractures. Our results also showed that Tubigrip was superior in terms of interference with a child's ADLs, stiffness and grip strength. However, there was no difference in the levels of pain, analgesia required, and deformity. CONCLUSION: These results support the idea that ultrasound is an effective and sensitive tool for detecting undisplaced greenstick and torus fractures of the distal radius in children. Treating these fractures with functional nonrigid devices (Tubigrip) results in improved function without increased discomfort or deformity.
RCT Entities:
OBJECTIVE: The management and the diagnostic modalities used in cases of undisplaced greenstick and torus fractures of the distal radius in children vary between different treatment centres. The aim of this study was twofold: firstly, to analyse the sensitivity of X-rays versus ultrasound to diagnose these fractures; secondly, to compare three available treatment options (plaster cast, Futuro splints, and double Tubigrip) in terms of pain, analgesia requirements, grip strength, deformity, stiffness and interference with a child's activities of daily living. METHODS: We prospectively included 79 patients suffering from undisplaced greenstick and torus fractures of the distal radius. Patients were randomized (single blindly) to the studied treatment groups. RESULTS: In terms of diagnosis, the ultrasound was found to be more sensitive than X-rays for diagnosing these fractures. Our results also showed that Tubigrip was superior in terms of interference with a child's ADLs, stiffness and grip strength. However, there was no difference in the levels of pain, analgesia required, and deformity. CONCLUSION: These results support the idea that ultrasound is an effective and sensitive tool for detecting undisplaced greenstick and torus fractures of the distal radius in children. Treating these fractures with functional nonrigid devices (Tubigrip) results in improved function without increased discomfort or deformity.
Authors: Daniel C Perry; Juul Achten; Ruth Knight; Susan J Dutton; Melina Dritsaki; James M Mason; Duncan E Appelbe; Damian T Roland; Shrouk Messahel; James Widnall; Phoebe Gibson; Jennifer Preston; Louise M Spoors; Marta Campolier; Matthew L Costa Journal: Health Technol Assess Date: 2022-07 Impact factor: 4.106
Authors: Ben A Marson; Simon Craxford; Sandeep R Deshmukh; Douglas Grindlay; Joseph Manning; Benjamin J Ollivere Journal: Bone Jt Open Date: 2020-07-21