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Cast and padding indices used for clinical decision making in forearm fractures in children
Sarvpreet Singh1, Maneesh Bhatia, Phil Housden
1King's College Hospital, Denmark Hill, London. sarvpreets@yahoo.com
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.
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