Using softcast to treat torus fractures in a paediatric emergency department

Area of Science:

• Pediatric Orthopedics
• Emergency Medicine
• Nursing Practice

Background:

• Wrist torus fractures are common pediatric emergency department (ED) visits.
• Traditional treatment involved backslab casting and Fracture Clinic referral.
• Variability in care prompted the development of standardized guidelines.

Purpose of the Study:

• To evaluate the efficacy and safety of soft cast immobilization for pediatric torus fractures managed by Advanced Nurse Practitioners (ANPs).
• To assess the impact of a standardized care pathway on patient outcomes and healthcare costs.

Main Methods:

• A retrospective review of 119 pediatric patients diagnosed with torus fractures treated by ANPs over one year.
• Treatment involved immobilization with soft casts.
• Data collected on adverse events and subsequent Fracture Clinic visits.

Main Results:

• No adverse events were recorded in the 119 patients treated with soft casts.
• None of the patients required follow-up visits to the Fracture Clinic.
• A cost saving of €18,596 was achieved compared to the traditional referral pathway.

Conclusions:

• ANP-led management of pediatric wrist torus fractures with soft casts is safe and effective.
• This standardized approach reduces the need for Fracture Clinic referrals and offers significant cost savings.
• Implementing such pathways can optimize ED resource utilization for common pediatric fractures.