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Topic:

Supracondylar Humerus Fracture

Issue:

Elbow

Category:

Trauma

Title:

Improved Comfortability and Satisfaction of Hybrid-mesh Casts in the Conservative Management of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial

Author:

Ong, Eric Jia Yong BSc (Hons); Lee, Nicole Kim Luan PhD; Mishra, Neeraj MRCS; Ng, Stacy Wei Ling FRCS; Chua, Zackary Kerk Hsiang FRCS; Yet, Lam Kai FRCS; bin Zainuddin, Mohammad Ashik FRCS; Lim, Kevin Boon Leong FRCS; Mahadev, Arjandas FRCS; Wong, Kenneth Pak Leung FRCS

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p 157-163, DOI: 10.1097/BPO.0000000000002579

Level Of Evidence:

II

# of Patients:

79

Study Type:

Randomized controlled trial (RCT)

Location:

Not specified

Summary:

This study compares hybrid-mesh (HM) casts to traditional fiberglass casts for the conservative management of stable pediatric supracondylar humeral fractures (SCHFs). It assesses patient comfort, satisfaction, and clinical outcomes.

Methods:

Inclusion Criteria: Pediatric patients with modified Gartland’s Type I and Type IIa SCHF. Intervention: Randomization into two groups—fiberglass cast vs. HM cast (for 3 weeks). Outcome Measures: Loss of reduction, skin rash, cast weight, breakage, duration of cast application/removal, and self-reported comfort and satisfaction using a questionnaire.

Exclusions:

Patients with non-closed fractures or fractures that required surgical intervention. Severe or multiple fractures. Patients who did not follow up for the necessary duration

Results:

Duration of Removal: HM casts required significantly longer time for removal than fiberglass casts (4.18±1.25 min vs. 2.25±0.55 min, P<0.001). Weight: HM casts were lighter than fiberglass casts (162.82±23.94 g vs. 203.95±36.52 g, P<0.001). Comfort: HM casts scored higher for comfort (4.05±0.887 vs. 3.47±0.951, P=0.007). Satisfaction: HM casts scored higher for satisfaction (3.69±1.055 vs. 3.11±0.953, P=0.012).

Conclusions:

Hybrid-mesh casts offer better comfort and overall satisfaction compared to fiberglass casts in the immobilization of pediatric SCHF, without compromising clinical outcomes.

Relevance:

Limitations:

Perspective:

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