Extension Casting For Both-Bone Forearm Fractures In Children

Paediatric forearm fractures are commonly treated with closed reduction and cast immobilization. Determining the best way to cast these fractures during the initial presentation may prevent the need for re-manipulation . An analysis of casting technique for all patients under eighteen years of age treated with closed reduction and cast immobilization for both-bone fractures of the forearm at a regional tertiary referral hospital over 7 years was undertaken. One-hundred and eighty-nine consecutive patients with 207 fractures were reviewed. No significant association was found between casting technique and failure rates (p=0.124). However, if manipulation and plaster was performed by a trainee, failure rates were significantly reduced when extension casting was utilized (p=0.029). Closed reduction and cast immobilization with the elbow in an extended position is an effective treatment option for both-bone forearm fractures in a paediatric population and is a safer option when performed by more junior staff-members.