Randomized Trial of Casting Techniques for Displaced Forearm Fractures

It is recognized that fractures of the distal radius and forearm occur in approximately one
in 100 children and adolescents every year. Though closed manipulation and cast
immobilization of displaced injuries is the mainstay of treatment in the majority of cases,
the optimal type of cast remains debatable. Though well-molded casts theoretically provide
the best ability to maintain fracture alignment, risks of circumferential immobilization in
acute injuries include neurovascular compromise. Splitting, or bivalving, casts may reduce
these risks, but the effect on fracture stability is unknown. The proposed investigation
seeks to address the simple question of whether circumferential or bivalved casts provide
the best outcomes.