Comparison of below the elbow cast with above the elbow cast in treating distal third forearm fractures in children

ABSTRACT

To compare the effectiveness of below the elbow cast with above the elbow cast in treating distal third forearm fractures in children. Comparative study. Orthopedic Department, PGMI Hayatabad Medical Complex Peshawar, from March 2010 to June 2011. This study was designed to compare above and below elbow casts for distal forearm fracture in patients aged 4-12 year. A total of 108 patients were managed during the study period. They were randomized into two groups of 54 each; group A above-elbow and group B below-elbow cast. The mean age of the children was 7.10 +/- 2.18 year. Males were 59.3% and females 40.7%. The right side was the dominant limb in both the groups. 19.6% of children in the above-elbow group required remanipulation as compared to 26.4% in the below elbow group with p value of 0.381. The time from injury to manipulation was not significantly different in the 2 groups. Differences between radius and ulna translation and angulation in the anteroposterior and lateral views of the x-rays were not significant. Twenty three children with above elbow cast and 19 children of below elbow cast had complications but the difference was not significant [p 0.324]. Three patients were lost to follow up. Below-elbow casts was as good as above-elbow cast in maintaining reduction of fractures in the distal third of the forearm in children