Cast and padding indices used for clinical decision making in forearm fractures in children.
OBJECTIVE
We assessed the reliability and practicality of two radiographic measurements--cast index and padding index--of the quality of plaster cast in clinical decision making in forearm fractures in children.


METHODS
40 orthopedic surgeons (20 consultants and 20 registrars) were asked to predict the risk of re-displacement in 5 randomly selected cases. Subsequently, these surgeons were taught these indices and they were then requested to use them to predict re-displacement.


RESULTS
Every one of the 40 surgeons showed an increase in the number of correct responses. For consultants, the accuracy improved from 33% to 72% and for the registrars it improved from 28% to 81%. This improvement was statistically significant.


CONCLUSIONS
We suggest that cast and padding indices are simple, reliable, and reproducible radio-graphic tools that can be used in clinics and wards to predict re-displacement of forearm fractures in children following initial reduction.
Singh
Sarvpreet
S
King's College Hospital, Denmark Hill, London. sarvpreets@yahoo.com
Bhatia
Maneesh
M
Housden
Phil
P
D002370:Casts, Surgical; D002648:Child; D003657:Decision Making; D005543:Forearm Injuries / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D011379:Prognosis; D011859:Radiography; D015203:Reproducibility of Results; D016896:Treatment Outcome