title: Management of Pediatric Forearm Torus Fractures: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  Pediatric forearm torus fracture, a frequent reason for emergency department visits, can be immobilized by both rigid cast and nonrigid methods. However, controversy still exists regarding the optimal treatment of the disease. The aim of this study was to compare, in a systematic review, clinical efficacy of rigid cast with nonrigid methods for immobilization of the pediatric forearm torus fractures.
  
  
  METHODS
  Literature search was performed of PubMed and Cochrane Library by 2 independent reviewers to identify randomized controlled trials comparing rigid cast with nonrigid methods for pediatric forearm torus fractures from inception to December 31, 2013, without limitation of publication language. Trial quality was assessed using the modified Jadad scale.
  
  
  RESULTS
  Eight randomized controlled trials with a total of 781 participants met all inclusion criteria. The nonrigid methods for immobilization included soft cast, splint, bandage, and slab. Results showed that nonrigid immobilizations had better clinical efficacy than rigid cast regarding functional recovery, treatment cost, and complication rate (relative risk, 3.02; 95% confidence interval, 1.70-5.37; P = 0.0002). Compared with rigid cast, more patients would like to choose the nonrigid methods of immobilization for future use. However, discrepant results sill surrounds the pain levels of the patients.
  
  
  CONCLUSIONS
  The current study suggests that the nonrigid immobilization methods have more advantages than rigid cast for immobilization of pediatric forearm torus fracture. The former strategies are also safe enough for clinical therapy.
authors.affiliation: From the *Department of Orthopaedics and Traumatology, †Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou; ‡Department of Minimally Invasive Spine Surgery, Second Affiliated Hospital to Inner Mongolia Medical University, Hohhot; and §Department of Spine Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.forename: Zhen-Hua
authors.initials: ZH
authors.lastname: Cao
authors.forename: Yun-Fei
authors.initials: YF
authors.lastname: Ma
authors.forename: Zhen
authors.initials: Z
authors.lastname: Lin
authors.forename: Bin
authors.initials: B
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D001458:Bandages / Q000009:adverse effects / Q000706:statistics & numerical data; D002370:Casts, Surgical / Q000009:adverse effects / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D009984:Orthopedic Fixation Devices / Q000009:adverse effects / Q000706:statistics & numerical data*; D011885:Radius Fractures / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D013165:Splints / Q000009:adverse effects / Q000706:statistics & numerical data; D016896:Treatment Outcome