- For pediatric buckle fractures of the wrist, full recovery is the norm, regardless of treatment used.
- This Cochrane review of randomized controlled trials (RCTs) finds no specific support for a given treatment but support for a move away from cast immobilization for buckle fractures.
Why this matters
- These distal radius fractures are the most common among children, and most of them are buckle fractures.
- Controversy continues over whether these fractures require immobilization.
- FORCE 2018 trial is ongoing .
- High risk for bias among all studies (little blinding).
- Removable splint vs cast did not produce different outcomes for device change, performance, refractures, pain.
- Splints might be more inexpensive.
- Soft bandage vs cast also yielded similar outcomes.
- 30 studies (21 RCTs) included (n=2930).
- Funding: University of Manchester, UK; Teesside University, Middlesbrough, UK, other.
- Those of included studies, including high bias risk.