The investigators provided results for the first 78 patients they have been able to evaluate since the patients were randomized to receive either a short-arm or long-arm cast for fractures of the distal third of the forearm, which represent 75% of all forearm fractures in children.
No significant differences have been seen in angulation, deviation, or displacement between the 46 patients who received long-arm casts and the 32 patients with short-arm casts.
There was actually a trend to more displacement in long-arm casts," said Dr.
He noted that casts must be properly molded, possibly explaining some of the displacement associated with long-arm casts.
Early in the study, some residents were constructing long-arm casts all at once, rather than applying a short-arm cast and molding it well before extending it up the length of the child's arm.
As expected, range of motion of the elbow was impaired at the initial follow-up in patients who had worn long-arm casts, but this difference disappeared over time after the casts were removed.
Ironically, among eligible patients who refused randomization, half of the families demanded a short-arm cast and half demanded a long-arm cast, said Dr.
Lifestyle differences represented the only significant differences in patients assigned to short-arm versus long-arm casts, the researchers concluded.