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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 ★★★☆☆☆☆
METHODS
Design:
randomised controlled non-inferiority trial.
Allocation:
{concealed*}†.
Blinding:
blinded (outcome assessors).*
Follow up period:
18 weeks.
Setting:
tertiary care hospital in Saskatoon, Saskatchewan, Canada.
Patients:
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.
Intervention:
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 …
Footnotes
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↵* See glossary. http://ebm.bmjjournals.com/cgi/content/full/11/4/???
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↵† Information provided by author.
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For correspondence:
Dr E R Bohm
Concordia General Hospital, Winnipeg, Manitoba, Canada. ebohm{at}concordiahospital.mb.ca -
Source of funding: Canadian Orthopedic Foundation.
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Reproduced with permission from Evidence-Based Medicine 2006;11:107