Below-elbow cast sufficient for treatment of minimally displaced metaphyseal both-bone fractures of the distal forearm in children: long-term results of a randomized controlled multicenter trial

Figures & data

Table 1. Baseline characteristics of the population. Values are count unless otherwise specified

Baseline	Below elbow cast	Above elbow cast
Number of children	25	26
Age at trauma (SD)	7.5 (1.4)	6.2 (1.4)
Male sex	12	10
Dominant arm	5	10
Type of fracture, radius
Buckle	0	2
Greenstick	16	17
Complete fracture	9	7
Type of fracture, ulna
Buckle	2	4
Greenstick	19	19
Complete fracture	4	3

Table 2. Representation of follow-up population

	Lost to FU	Included	Total
	(95% CI)	(95% CI)	(95% CI)
Outcome at 7 months follow-up	n = 15	n = 51	n = 66
Age at trauma, years	7.9 (6.1–9.8)	6.8 (5.8–7.8)	7.1 (6.2–7.9)
Male sex, n	8	29	37
Forearm rotation 7 months (°)	148 (144–153)	139 (131–148)	146 (142–150)
Loss of rotation (°)	4.9 (2.9–6.9)	4.3 (0.6–8.1)	4.8 (3.1–6.5)
ABILHAND-kids questionnaire (points)	41.4	41.7	41.6
Complications (%)	13	16	15
VAS cosmetics parents/child (0–10)	9.6	9.4	9.4
VAS cosmetics surgeon (0–10)	9.8	9.7	9.7

Table 3. Data (95% confidence intervals) on primary and secondary outcomes at long-term follow-up

	Below elbow cast	Above elbow cast
Factor	n = 25	n = 26
Age at follow-up, years	14.9 (13.3–16.5)	13.2 (11.8–14.7)
Follow-up length, years	7.5 (6.9–8.0)	7.1 (6.5–7.7)
Loss of forearm rotation	–0.72 (–4.5 to 3.1)	0.58 (–5.1 to 6.2)
Loss of wrist flexion–extension	0.80 (–3.2 to 4.8)	0.58 (–2.4 to 3.5)
ABILHAND-kids
questionnaire (points)	41.4 (40.1–42.7)	41.9 (41.5–42.3)
DASH score (points)	4.4 (0–13)	2.1 (0–6.9)
Grip strength, kg	31 (17–45)	28 (14–42)
VAS cosmetics parents (0–10)	9.4 (9.0–9.8)	9.3 (8.9–9.7)
VAS cosmetics surgeon (0–10)	9.7 (9.5–9.9)	9.6 (9.4–9.9)

Table 4. Radiological angulation (°) (95% confidence intervals)

View	Below elbow cast		Above elbow cast
	Cast removal	Final	Cast removal	Final
Anteroposterior
Ulna	7 (2–12)	5 (2–8)	6 (2–10)	5 (2–8)
Radius	4 (0–8)	6 (3–9)	4 (0–8)	5 (1–9)
Lateral
Ulna	6 (2–10)	4 (1–7)	6 (3–9)	4 (2–6)
Radius	10 (5–15)	5 (2–8)	10 (5–15)	4 (1–7)

Cast removal at 6 weeks after casting