Cast Wedging in Pediatric Forearm and Tibia Fractures-A Safe Way to Avoid Surgery

Area of Science:

• Orthopedic Surgery
• Pediatric Traumatology
• Fracture Management

Background:

• Cast wedging is a standard method for correcting pediatric fracture alignment.
• Evaluating its effectiveness and complication rates is crucial for pediatric fracture care.

Purpose of the Study:

• To assess the efficacy of cast wedging in treating malaligned pediatric fractures.
• To determine the incidence of complications and treatment failures associated with cast wedging.

Main Methods:

• Retrospective review of 294 pediatric patients (ages 3-18) treated with cast wedging for forearm or tibia shaft fractures.
• Radiographic measurements assessed angular correction (≥50% considered successful).
• Multivariable logistic regression identified factors influencing outcomes.

Main Results:

• Median angular correction was 56%, with 74% achieving ≥50% correction.
• Treatment failure occurred in 7% of patients, with 55% requiring repeat reduction.
• Complications were observed in 6%, and refracture in 3%.

Conclusions:

• Cast wedging is a safe and effective technique for correcting pediatric fractures.
• It demonstrates a low incidence of complications and refracture.
• It remains an essential skill for orthopedic surgeons managing pediatric fractures.