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SOFT CAST VERSES PLASTER OF PARIS IN TREATMENT OF GREENSTICK FOREARM FRACTURES IN CHILDREN



Abstract

Introduction: To compare soft cast (SC) with plaster of paris (POP) in treatment of greenstick fractures in children.

A prospective randomised study analysing and comparing the two types of treatment in terms of patient and medical staff satisfaction, duration of treatment, pain during treatment. Wrist movement after removal of plaster, and the cast quality . An approval to conduct the study obtained from trust ethic committee

Material and method: We identified 87 children (46 females and 41 males) referred to our clinic between September 1999 and June 2000 with forearm greenstick fractures. Patient and parents approached to participate and given written information about the trail if agreed consente obtained and patients randomised in to two groups using sealed envelopes. Those treated with a traditional hard cast (POP), and those treated with 3M soft cast tape (SC). A clinical details and progress form completed for each patient a questionnaire was completed by patients designed to score their overall satisfaction with treatment. Another questionnaire for clinicians score their satisfaction with cast quality and handling.

Results: A total of 61 patients completed the trail. 26 patients either declined the study after consent or lost during follow up. 29 patients had (SC) and 32 had (POP). The mean age was 8.88years for (SC) group and 8.34 years for (POP) group. The average treatment period was 22.7days for (SC) group and 23.1 for (POP) group. The average patient score for pain and satisfaction was 8.88 for (SC) group and 8.13 for the (POP) group with P value of 0.632. . [0 for Poor and 10 for excellent]. The average clinician satisfaction score was 8.7 for (sc) group and 8.03 for the (pop) group. With p value of 0.22. [0 for Poor and 10 for excellent]. 92% of the (SC) group achieved excellent wrist range of movement compared with 88% of the (POP) group.

Conclusion: We concluded that although each type of cast has its own advantages and disadvantage however when used in treatment of greenstick forearm fractures in children they produce comparable results. with on statistical differences.

Honorary Secretary Mr Bimal Singh. Correspondence should be addressed to BOSA (British Orthopaedic Specialists Association), c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PE.