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Biobased polyester versus synthetic fiberglass casts for treating stable upper limb fractures in children: a
Tsung-Yu Lan1,2,3, Chin-Wen Chen4,5,6, Yu-Hao Huang1
1Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd, New Taipei City, 220, Taiwan (R.O.C.).
Insights
A new biobased polyester cast offers similar stability to traditional fiberglass casts for pediatric fractures. This eco-friendly option significantly reduces skin issues and improves patient comfort, making it a safer alternative.
Area of Science:
- Orthopedic Traumatology
- Biomaterials Science
- Pediatric Care
Background:
- Stable pediatric upper limb fractures (radius, ulna, distal humerus) are common.
- Traditional synthetic fiberglass casts, while effective, are linked to patient discomfort (itchiness) and potential health risks (diisocyanate toxicity, asthma).
- A novel biobased polyester cast has been developed as a potentially safer and more comfortable alternative.
Purpose of the Study:
- To compare the clinical outcomes and patient satisfaction of a novel biobased polyester cast versus conventional synthetic fiberglass casts in children with stable upper limb fractures.
Main Methods:
- A single-center prospective randomized trial was conducted with 100 pediatric patients.
- Patients were randomized into either a biobased polyester cast group or a synthetic fiberglass cast group.
- Follow-up occurred over 3-4 weeks until cast removal, with objective clinical and subjective questionnaire data collected.
Main Results:
- Radiographs confirmed no loss of fracture reduction in either group post-immobilization.
- The incidence of skin problems was 3.4 times higher in the synthetic fiberglass group compared to the biobased polyester group.
- Patient questionnaires indicated a preference for the biobased polyester cast across all assessed criteria.
Conclusions:
- The novel biobased polyester cast demonstrates comparable stability to traditional fiberglass casts for pediatric upper limb fractures.
- This biobased cast significantly enhances patient satisfaction and reduces skin complications.
- The study suggests a safer, eco-friendlier alternative for pediatric fracture immobilization.
Background:
Stable upper limb fractures, such as radius, ulna, or distal humerus fractures, are common pediatric orthopedic traumas that are traditionally managed with cast immobilization. The commonly used synthetic fiberglass cast is light and water resistant but may promote skin itchiness during casting, which is a common complaint of patients. In addition, these diisocyanate-based casts have been proven to be toxic and may cause asthma. Herein, we introduce a novel biobased polyester cast to compare its clinical outcomes and patient satisfaction with conventional synthetic fiberglass casts.
Methods:
From Feb 2022 to Nov 2022, we undertook a single-center prospective randomized trial involving 100 children with cast-immobilized stable upper limb fractures. These patients were randomized into either biobased polyester or synthetic fiberglass groups. All patients were regularly followed up till the cast removal which occurred approximately 3-4 weeks after immobilizing. Objective clinical findings and subjective patient questionnaire were all collected and analyzed.
Results:
According to the radiographs taken on the day of cast removal, there was no loss of reduction in both groups. The incidence of skin problems was 3.4 times higher in the synthetic fiberglass group than in the biobased polyester group. For the subjective questionnaire, the biobased polyester cast was preferred in every sub-item.
Conclusions:
Our study strongly suggested that the novel biobased polyester cast provides matching stability to conventional fiberglass casts and improves patient satisfaction in an eco-friendlier and safer way.
Trial Registration:
ClinicalTrials.gov Protocol Registration and Results System ( https://www.
Clinicaltrials:
gov/ ; ID: NCT06102603; Date: 26/10/2023).
