![]() ![]() Each colour was a code for the treatment that would be applied to the child, be it a plaster cast, a Futuro wrist splint, or a double Tubigrip. The child was offered an opaque pot containing equal numbers of sweets of three different colours in such a way that they could not see what colour they were picking. All patients meeting the criteria received a plain X-ray in the accident and emergency department, and also received an ultrasound scan of the injury within the first 2–3 days of the injury (mean 1.4 days) using an Aloka SSD-500 echo camera ultrasound machine (Aloka Co., Japan) with a 7.5 MHz probe. The term “minimally angulated” was defined as a complete absence of any discernible clinical deformity, which on a plain X-ray would be less than 10° of angulation in any plane. Inclusion criteria included all children aged 0–16 sequentially attending our treatment centre, at the University Hospitals of Coventry and Warwickshire, who had sustained a minimally angulated greenstick or torus fracture of the distal third of the radius, as confirmed by either X-ray or ultrasound. X-ray and ultrasound of the injured limb was performed on every patient at the initial visit to the clinic, and at a follow-up visit within 4–6 weeks. Three treatment regimes assigned randomly, using either plaster cast, Futuro wrist splints or double Tubigrip, were evaluated. This study was designed to try to answer these questions. Will it be too painful for the child? Will it be adequate to prevent further injury or displacement of the fracture? Do splints in children cause unnecessary stiffness, weakness, and interference with a child’s activities of daily living, which can be minimised through early functional treatment if applied appropriately? Is an X-ray required for the diagnosis, or is ultrasound an alternative investigation? Questions that often arise whenever such stable fractures in children are treated with minimal splintage and early function include the following. Stable fractures of the ankle in children have been successfully treated with double Tubigrip devices, and outcomes are superior to those treated with plaster cast immobilisation. The literature suggests that in other long bones where stable fractures exist, early functional treatment, avoiding splints and immobilisation lead to superior results. ![]() These fractures are usually stable and heal without difficulty. Follow-up arrangements may or may not be made, with some centres performing further X-rays. Alternative treatment includes immobilization with a Futuro wrist splint. The treatment most commonly offered includes immobilization for a short period of time in plaster-of-Paris, either a backslab or a full cast. The diagnosis is established mainly by the clinical findings and confirmed by plain X-rays. The management of minimally angulated greenstick and torus fractures of the distal radius in children varies between different centres.
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