Cast and padding indices used for clinical decision making in forearm fractures in children

Abstract

Purpose We assessed the reliability and practicality of two radiographic measurements—cast index and padding index—of the quality of plaster cast in clinical decision making in forearm fractures in children.

Methods 40 orthopedic surgeons (20 consultants and 20 registrars) were asked to predict the risk of re‐displacement in 5 randomly selected cases. Subsequently, these surgeons were taught these indices and they were then requested to use them to predict re-displacement.

Results Every one of the 40 surgeons showed an increase in the number of correct responses. For consultants, the accuracy improved from 33% to 72% and for the registrars it improved from 28% to 81%. This improvement was statistically significant.

Interpretation We suggest that cast and padding indices are simple, reliable, and reproducible radio‐graphic tools that can be used in clinics and wards to predict re‐displacement of forearm fractures in children following initial reduction.

Contributions of authors

SS and MB did the data collection and wrote the manuscript together, under the guidance of PH.