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In children with a closed fracture of the distal third of the forearm, are below the elbow casts as effective as above the elbow casts?
Clinical impact ratings GP/FP/Primary care ★★★★☆☆☆ Orthopaedics ★★★★★★☆ Emergency medicine ★★★★☆☆☆ Paediatrics ★★★☆☆☆☆
randomised controlled non-inferiority trial.
blinded (outcome assessors).*
Follow up period:
tertiary care hospital in Saskatoon, Saskatchewan, Canada.
117 children 4–12 years of age who presented with a closed fracture of the distal third of the forearm requiring reduction. Children with open factures or Salter Harris type III or IV fractures were excluded.
below the elbow (n = 46) or above the elbow (n = 56) cast was applied after closed reduction of the fracture. Reduction was done under conscious sedation in the emergency department within 4 hours, or under general anaesthesia in the operating room within 24 hours. Follow up …
↵* See glossary. http://ebm.bmjjournals.com/cgi/content/full/11/4/???
↵† Information provided by author.
Dr E R Bohm
Concordia General Hospital, Winnipeg, Manitoba, Canada.
Source of funding: Canadian Orthopedic Foundation.
Reproduced with permission from Evidence-Based Medicine 2006;11:107
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