Soft bandage, splint or cast as the treatment of distal forearm torus fracture in children: a systematic review and meta-analysis.

Autor: Pakarinen O; Faculty of Medicine, University of Helsinki, Helsinki, Finland. oskari.pakarinen@gmail.com.; Päijät-Häme Central Hospital, Lahti, Finland. oskari.pakarinen@gmail.com., Saarinen AJ; Department of Surgery, Central Finland Hospital Nova, Jyvaskyla, Finland., Ponkilainen VT; Department of Surgery, Central Finland Hospital Nova, Jyvaskyla, Finland., Uimonen M; Department of Surgery, Central Finland Hospital Nova, Jyvaskyla, Finland., Helenius I; Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.; Department of Paediatric Orthopaedics, Helsinki University Hospital, New Children's Hospital, Helsinki, Finland., Kuitunen I; Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.; Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Sep 09; Vol. 14 (1), pp. 21052. Date of Electronic Publication: 2024 Sep 09.
DOI: 10.1038/s41598-024-71970-7
Abstrakt: A meta-analysis including all relevant randomized controlled trials was conducted to compare soft bandage, splint and cast as the treatment of torus fracture. PubMed, Scopus, and Web of Science databases were searched in January 2023. Two comparisons were made: (1) splint versus cast, and (2) bandage versus rigid immobilization (i.e. splint or cast). Main outcomes were pain, clinical healing of the fracture and return to activities. Secondary outcomes were adverse events (skin issues, problems with cast/splint/bandage) and patient/parental satisfaction. Seven studies with 1550 patients were included. Splint was associated with higher pain scores at 3 days compared to cast (Mean difference [MD] 1.00, CI 0.06-1.94) and at 1 week (MD 1.46, CI 0.84-2.08, moderate-certainty evidence), but faster return to activities (at 3 weeks RR 1.77, CI 1.09-2.88, at 4 weeks RR 1.44, CI 1.11-1.82, moderate-certainty evidence). All torus fractures heal clinically within 3-4 weeks (low-certainty evidence). Bandage may lead to slightly higher pain score (MD 0.35, CI 0.04-0.66, moderate-certainty evidence) at first day after treatment compared to rigid immobilization, but no evidence of a difference was found in later time points. In conclusion, soft bandage or removable wrist splint seem to be optimal first-line treatment of distal forearm torus fracture.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje