An Evidence-Based Approach to Casting and Orthosis Management of the Pediatric, Adolescent, and Young Adult Population for Injuries of the Upper Extremity: A Review Article

Abstract

Objective: Review the use of upper-extremity orthoses and casts after injuries to the wrist and hand in the pediatric, adolescent, and young adult population. The common injuries reviewed include pediatric distal radius fractures, scaphoid fractures, metacarpal fractures, mallet fingers, volar plate injuries of the proximal interphalangeal (PIP) joint, and ulnar collateral ligament (UCL) tears of the thumb metacarpophalangeal (MCP) joint. Data Sources: We conducted a literature review from 1985 to 2016 of upper-extremity orthotic interventions. Non–English language citations and animal studies were excluded. Citations from retrieved studies were used to identify other relevant publications. This review included cases of common injuries to the upper extremity, which required orthotic intervention. Main Results: Immobilization recommendations for nonsurgical pediatric distal radius fractures, nonsurgical metacarpal fractures, mallet fingers, and UCL tears of the thumb MCP include a removable orthosis. Nondisplaced scaphoid fracture orthosis recommendations include initial immobilization in a nonremovable short-arm thumb spica cast. Volar plate injuries of the PIP joint require buddy straps for healing. Conclusions: The literature demonstrates the effectiveness of removable orthoses in healing, patient satisfaction, and time to return to activity after many common upper-extremity injuries. Removable orthoses should be considered an equal or superior treatment method to cast immobilization, immobilization of additional joints, or longer periods of immobilization.

Return to sport after forearm fractures in children: A scoping review and survey

“…Twenty-two publications were included for data extraction (Figure 1). Sixteen studies 6,8,16,[18][19][20][21][22][23][24][25][26][27][28][29][30] related to specific fractures (Table 5), while six studies 14,[31][32][33][34][35] made general recommendations (Table 6).…”

Orthosis use after Beirut Port ammonium nitrate explosion

“…Physical therapists who use splinting put emphasis on simplicity, cost accountability, and their wide application such as external fixation or traction after primary surgery, fostering nerve recuperation after repair, as a compensatory measure for a permanent injury. 4,5 The current report emphasizes the convenient effective treatment of hand injuries by removable orthoses after a mass disaster.…”

Brace versus cast following surgical treatment of distal radial fracture: a prospective randomised study comparing quality of recovery

“…The use of a brace for stabilisation following DRF has now gained increased interest, and studies have shown high patient acceptance. [3][4][5] There is, however, sparse information on the effect of the use of brace following surgical treatment of DRF in adult patients. 6,7 Self-assessed quality of recovery (QoR) questionnaires evaluating the postoperative course in a multi-dimensional perspective have gained increasing interest.…”

“…The use of a brace for stabilisation following DRF has now gained increased interest, and studies have shown high patient acceptance. 3 - 5 There is, however, sparse information on the effect of the use of brace following surgical treatment of DRF in adult patients. 6 , 7 …”