title: Early conversion to below-elbow cast for non-reduced diaphyseal both-bone forearm fractures in children is safe: preliminary results of a multicentre randomised controlled trial.
abstract: BACKGROUND
  This multicentre randomised controlled trial was designed to explore whether 6 weeks above-elbow cast (AEC) or 3 weeks AEC followed by 3 weeks below-elbow cast (BEC) cause similar limitation of pronation and supination in non-reduced diaphyseal both-bone forearm fractures in children.
  
  
  METHODS
  Children were randomly allocated to 6 weeks AEC or to 3 weeks AEC followed by 3 weeks BEC. The primary outcome was limitation of pronation and supination after 6 months. The secondary outcomes were re-displacement of the fracture, complication rate, limitation of flexion and extension of wrist and elbow, cast comfort, cosmetics, complaints in daily life and assessment of radiographs.
  
  
  RESULTS
  A group of 23 children was treated with 6 weeks AEC and 24 children with 3 weeks AEC and 3 weeks BEC. The follow-up rate was 98 % with a mean follow-up of 7.0 months. The mean limitation of pronation and supination was 23.3 ± 22.0 for children treated with AEC and 18.0 ± 16.9 for children treated with AEC and BEC. The other study outcomes were similar in both groups.
  
  
  CONCLUSIONS
  Early conversion to BEC is safe in the treatment of non-reduced diaphyseal both-bone forearm fractures in children.
  
  
  METHODS
  Multicentre randomised controlled trial, Level II.
authors.affiliation: Department of Orthopaedic Surgery, Erasmus Medical Center, Westzeedijk 361, Postbus 2040, 3000 CA, Rotterdam, The Netherlands, j.colaris@erasmusmc.nl.
authors.forename: Joost W
authors.initials: JW
authors.lastname: Colaris
authors.forename: Max
authors.initials: M
authors.lastname: Reijman
authors.forename: Jan Hein
authors.initials: JH
authors.lastname: Allema
authors.forename: L Ulas
authors.initials: LU
authors.lastname: Biter
authors.forename: Rolf M
authors.initials: RM
authors.lastname: Bloem
authors.forename: Cees P
authors.initials: CP
authors.lastname: van de Ven
authors.forename: Mark R
authors.initials: MR
authors.lastname: de Vries
authors.forename: Albert J H
authors.initials: AJ
authors.lastname: Kerver
authors.forename: Jan A N
authors.initials: JA
authors.lastname: Verhaar
mesh_terms: D000293:Adolescent; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008349:Manipulation, Orthopedic; D011885:Radius Fractures / Q000628:therapy*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000628:therapy*; D014955:Wrist Joint / Q000502:physiology