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Randomized Control Trial: Elbow Extension Versus Flexion Cast in Proximal Half Both Bone Forearm Fractures

Not Applicable
Conditions
Fracture of Radius and Ulna
Interventions
Other: Cast
Registration Number
NCT05470257
Lead Sponsor
University of Alabama at Birmingham
Brief Summary

The purpose of this study is to compare outcomes between two immobilization methods for pediatric proximal half both bone forearm fractures.

Detailed Description

After being informed of the study including potential risks and benefits, all patients giving assent and guardian/parents consent who meet eligibility will undergo randomization of the casting technique used (elbow extension or elbow flexion casting). Randomization will occur using a random umber generator. Even numbers generated will result in an extension cast and odd numbers generated will result in a flexion cast.

The patients will be followed in clinic with an examination and x-rays at 2, 3, 5, and 8 weeks after casting to evaluate alignment of the fracture maintained by each cast. The two cohorts will be compared at the end of the study to determine which casting technique is the superior immobilization for pediatric proximal half both bone forearm fractures.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
75
Inclusion Criteria
  • Ages 3-18
  • Skeletally immature
  • Unilateral Radius and Ulna Fracture located within the proximal ½ of each bone
  • Fracture requires reduction and casting
Exclusion Criteria
  • Ages < 3
  • Distal ½ Radius and Ulna Forearm Fracture
  • Isolated radius or ulna fracture
  • Humerus Fracture of the Ipsilateral Arm (including floating elbow)
  • Metabolic Bone Disease
  • Open Fractures
  • Monteggia and Galeazzi Fractures
  • Deformity or abnormality not allowing for standard casting (limb deficiency, contracture)
  • Parent speaks language other than english

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Elbow Flexion CastCastThis cohort will be placed in a long arm flexion cast.
Elbow Extension CastCastThis cohort will be placed in a long arm extension cast.
Primary Outcome Measures
NameTimeMethod
Alignment/Loss of ReductionThis will be accessed in clinic via x-rays until 8 weeks status post cast application.

During clinic visits, xrays will be obtained to measure alignment of the radius and ulna fracture and asses for loss of reduction or malalignment. We will compare the number of patients with proximal both bone forearm fractures that have lost alignment after 8 weeks between the flexion elbow cast cohort compared to the extension elbow cast cohort.

Secondary Outcome Measures
NameTimeMethod
Cast ComplicationsCasting complications will be followed the full duration of the patient wearing a cast, which is expected to be around 6-8 weeks.

We will compare the casting complications between elbow extension versus elbow flexion casting cohorts. Casting complications we will observe will be cast saw burns, cast slipping, and need for bivalve of casts.

Trial Locations

Locations (1)

Children's of Alabama

🇺🇸

Birmingham, Alabama, United States

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