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Published on: August 14, 2018
Short Leg Cast Versus Long Leg Cast Immobilization for Pediatric Tibia Fractures: A Systematic Review and
Alma Sato1, Yasmine J Khair1, Angelica Pashou1
1University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.
Journal of Pediatric Orthopedics
|June 19, 2026
Summary
Short leg casts (SLC) may be a viable alternative to long leg casts (LLC) for pediatric tibial fractures, showing similar healing and complication rates. SLCs were associated with faster weight-bearing and union times in this review.
Area of Science:
- Orthopedics
- Pediatric Traumatology
- Evidence-Based Medicine
Background:
- Pediatric tibial fractures are common, but optimal immobilization remains unclear.
- Comparative effectiveness of short leg casts (SLC) versus long leg casts (LLC) is not well-established.
Purpose of the Study:
- To compare the effectiveness and safety of SLC versus LLC for pediatric tibial fractures.
- To evaluate healing stability, functional recovery, and complication rates.
Main Methods:
- Systematic review and meta-analysis of retrospective comparative studies (Level III evidence).
- Literature search of Medline, CINAHL, Embase, and Cochrane Library up to August 2025.
- Random-effects model for statistical analysis following PRISMA guidelines.
Main Results:
- Six studies with 413 pediatric patients were included (163 SLC, 250 LLC).
- No significant differences in coronal or sagittal angulation, cast duration, or overall complication rates between SLC and LLC.
- SLC associated with shorter time to weight-bearing and faster time to union.
Conclusions:
- SLC may be considered an alternative to LLC for pediatric tibial shaft and distal tibial physeal fractures.
- Evidence is limited by retrospective designs and heterogeneity; further prospective studies are needed.
- Optimal indications for SLC require further definition through prospective research.
