Do wrist guards protect against fractures?
OBJECTIVE
To determine whether wrist guards increase the fracture threshold for wrist and forearm fractures.


METHODS
We conducted a controlled, blinded experimental study using matched cadaveric arms-one fitted with a wrist guard-dropped with the use of a device designed to simulate a fall. We measured the mean number of drops before the occurrence of fracture, mean height and velocity change to fracture, mean kinetic energy, mean peak acceleration (in Gs), and summed impulse [weight (kilograms) x delta velocity (meters/second)] to fracture with and without wrist guards. Fracture severity was compared with the use of an ordinal ranking system and analyzed with the Mann-Whitney rank-sum test.


RESULTS
Wrist guards were associated with a statistically significant increase in the number of drops, mean drop height, mean kinetic energy, and summed impulse required to cause a fracture. Fractures also tended to be less severe when wrist guards were used.


CONCLUSIONS
The biomechanical evidence of a protective effect of wrist guards against wrist fractures seen in this study, coupled with previous epidemiologic evidence, is strong enough to warrant pediatricians, family practitioners, and emergency physicians to counsel skaters to use these devices when using roller skates, skateboards, or in-line skates.
Lewis
L M
LM
Emergency Medicine Division, Barnes-Jewish Hospital, St Louis, MO, USA.
West
O C
OC
Standeven
J
J
Jarvis
H E
HE
D000054:Acceleration; D000058:Accidental Falls; D001696:Biomechanical Phenomena; D001835:Body Weight; D001915:Braces / Q000592:standards*; D002102:Cadaver; D005543:Forearm Injuries / Q000517:prevention & control*; D050723:Fractures, Bone / Q000517:prevention & control*; D006801:Humans; D015601:Injury Severity Score; D011482:Protective Devices / Q000592:standards*; D016037:Single-Blind Method; D014954:Wrist Injuries / Q000517:prevention & control*