Distal radius fractures:  what is the evidence?
OBJECTIVE
To discuss the evidence base behind treatment of pediatric distal radius fractures.


METHODS
We identified randomized controlled trials addressing the treatment of children with torus fractures, minimally displaced fractures, and displaced fractures of the distal radius.


RESULTS
Torus fractures and minimally displaced fracture is treated by removable splints instead of circumferential casts with improved secondary outcomes for the patient and family and with equal position at healing. Case immobilization versus immediate pinning was studied in 2 small randomized trials of displaced fractures. Long-term outcomes were equivalent, despite more loss of reduction in the cast groups and more pin complications in the pin groups.


CONCLUSIONS
Unbiased evalution of empirical patient outcomes using randomized trials has proven feasible for distal radius fractures and should continue to inform and guide our practice in the future.
Children's Hospital Boston, USA.
Donald S
DS
Bae
Andrew W
AW
Howard
D001858:Bone Nails; D002370:Casts, Surgical; D002648:Child; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011885:Radius Fractures / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome