Clinical and radiographic comparison of single-sugar-tong splint to long-arm cast immobilization for pediatric forearm fractures

Robert F Murphy, Leah Plumblee, Brian Sleasman, William Barfield, Matthew A Dow, James F Mooney
Journal of Pediatric Orthopedics. Part B 2018 December 6
The purpose of this study was to compare the efficacy of a single-sugar-tong splint (SSTS) to a long-arm cast (LAC) in maintaining reduction of pediatric forearm fractures, while avoiding secondary intervention. One hundred patients age 3-15 with a forearm fracture requiring a reduction and immobilization were evaluated (50 LAC and 50 SSTS). Medical records and radiographs were reviewed at injury, postreduction, and at 1, 2, and 4 weeks postinjury. Sagittal and coronal angular deformities were recorded. Any secondary intervention due to loss of reduction was documented. The groups were matched by age (P=0.19), sex (P=0.26), mechanism of injury (P=0.66), average injury sagittal deformity (LAC 27.4°, SSTS 25.4°; P=0.50), and average injury coronal deformity (LAC 15.5°, SSTS 16°; P=0.80) At 4 weeks postinjury follow-up, there were no statistically significant differences between use of an SSTS or LAC when comparing postimmobilization sagittal alignment (LAC 10.3±7.2, SSTS 8.4±5.1°; P=0.46), coronal alignment (LAC 6.9±4.6, SSTS 7.6±9.3°; P=0.46), or need for repeat manipulation or surgery (LAC 4/50, SSTS 3/50; P=0.70).

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