Children's daily living activities during immobilization of upper-limb fractures with an above- or below-elbow cast

Abstract

Background The purpose of this prospective study was to assess the impact of cast immobilization on the activities of daily living in children with fractured upper limbs. Methods Using the Activities Scale for Kids (ASK), 52 consecutive children (17 girls, 35 boys), aged 5-15 years (mean, 9 years), with upper limb fractures treated by means of above-or below-elbow casts were assessed. The files were reviewed for background and fracture-related data. Results Mean score of the above-elbow group was 65.4 ± 15.5 points on the ASK capability domain (ASK-c) (with cast) and 98.7 ± 3 points on the ASK-performance domain (without cast). Corresponding scores for the belowcast group were 89.8 ± 13 and 99.5 ± 2. Factors that positively affected overall function were older age, male sex, shorter duration of pain, and less displacement. On multivariate analysis, only age proved to be a potential predictive factor. Cast position and hand dominance had no effect. The specific activities affected were personal hygiene, dressing, making a snack, and reaching high objects. ConclusionsTo ease their children's adjustment to forearm cast immobilization after fractures, parents should be educated in the areas of daily living that may be affected. This is particularly true for younger children with more displaced fractures that cause more pain.

Testing a new method of osteosynthesis of forearm fractures in children; a prospective randomized controlled longitudinal study

“…Twenty children were included in our study as a convenience sample and block-randomized (10 + 10) to either conventional surgery (5 KW/5 ESIN) or MIROS (10). The gender ratio for male:female was 4:1 with a mean age of 8.9 years (range: [4][5][6][7][8][9][10][11][12][13][14][15]. The relationship between groups of osteosynthesis and distribution of gender (χ 2 ; p = 0.582) or age (χ 2 ; p = 0.475) was nonsignificant.…”

“…This can lead to inconvenient swelling and stiffness of the wrist and elbow joints. 13 - 15 The “Minimally Invasive Reduction and Osteosynthesis System” (MIROS) might be able to address this particular fracture. This system supposedly combines the benefits of external fixation and intramedullary nailing with the advantages of being minimally invasive and providing adequate fracture stability, thus omitting the need for postoperative casting.…”