Clinical and radiographic comparison of single-sugar-tong splint to long-arm cast immobilization for pediatric forearm fractures

Murphy, Robert F.; Plumblee, Leah; Sleasman, Brian T.; Barfield, William R.; Dow, Matthew A.; Mooney, James F.

doi:10.1097/bpb.0000000000000572

Cited by 4 publications

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“…Study by Lee et al, 4 showed that loss of reduction occurred in 16 cases in short arm double splint group (34%) and 10 cases in sugar-tong splint group (29.4%), which did not differ significantly between the groups (p-value= 0.169). Murphy et al, 17 concluded that at four weeks post-injury follow-up, there were no statistically significant differences between use of an SSTS or LAC when comparing post-immobilisation sagittal alignment (LAC 10.3±7. 20 In the previous study by Colaris et al, 19 the results in the LACalone group were excellent in 21%, good in 38%, fair in 26%, and poor in 15%.…”

Section: Discussionmentioning

confidence: 99%

Functional outcome of long-arm cast versus double sugartong splint in acute paediatric distal forearm fractures: A randomised controlled trial

Banjade

Adhikari

et al. 2022

J. Kathmandu Med. Coll.

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Background: The treatment of choice for paediatric distal forearm fractures has been a long-arm cast (LAC) following closed reduction. An alternative treatment is to use a double sugar-tong splint (DSTS), found equally effective to provide three-point fixation and comparable outcomes to cast. Objectives: To compare the functional outcome between LAC and DSTS for the treatment of paediatric distal forearm fractures. Methods: A randomised controlled trial was done among 36 patients of 5-15 years with acute distal forearm fractures without neurovascular deficit treated with LAC and DSTS recruited by convenience sampling at a tertiary care centre after ethical approval. Acceptability of reduction, loss of reduction, union rates, cast comfort, range of motion and complications were studied at follow-up upto 12 weeks and analysed using SPSS v.11.5. Results: Among a total of 36 patients, 18 cases were treated by the LAC method and others by the DSTS method. Both LAC and DSTS were comparable in the maintenance of reduction, the remanipulation rate was 8.3% (n = 3), not significant (p-value = 0.967). All had a union at six weeks follow-up. No statistical difference in mean VAS score (p-value = 0.524), mean loss of flexion (p-value = 0.397), and mean loss of pronation/supination (p-value = 0.814). No statistically significant difference in activities of daily living was noted. No complications were encountered. Conclusion: DSTS is safe and as effective as LAC in the treatment of distal forearm fractures in children, identical in terms of functional outcome, maintenance of reduction, complications, and time to union.

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Section: Discussionmentioning

confidence: 99%

Functional outcome of long-arm cast versus double sugartong splint in acute paediatric distal forearm fractures: A randomised controlled trial

Banjade

Adhikari

et al. 2022

J. Kathmandu Med. Coll.

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“…Since the risk of alignment changes after the fourth week in this age group is very low, the fourth week was chosen as the endpoint for radiological measurements. [ 7 ] At the time of admission, immediately after the reduction, the first-week, second-week, and fourth-week controls were analyzed. The types of fractures were recorded.…”

Section: Methodsmentioning

confidence: 99%

“…[ 3 - 6 ] There are different immobilization methods to maintain reduction in the conservative treatment of forearm fractures, such as short arm casts (SACs), long arm casts (LACs), single sugar-tong splints (SSTS) or double sugar-tong splints (DSTS). [ 7 ] Although the traditional immobilization method for pediatric distal forearm fractures is LAC, SAC and sugar-tong splints (STS) have shown satisfactory results in recent years. [ 4 , 7 - 9 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 7 ] Although the traditional immobilization method for pediatric distal forearm fractures is LAC, SAC and sugar-tong splints (STS) have shown satisfactory results in recent years. [ 4 , 7 - 9 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 11 , 12 ] Recent studies have reported that STS are as successful as traditional circular casting in the treatment of these fractures. [ 7 , 8 , 13 ] Moreover, there is no need for splitting, and it prevents saw-related complications and loss of time.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of two immobilization methods in the conservative treatment of pediatric distal forearm fractures: Long arm cast versus single sugar-tong splint

Engin Daştan,

Vahabi,

Aljasim

et al. 2023

Jt Dis Relat Surg

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Objectives The aim of this study was to compare the results of single sugar-tong splint (SSTS) and long arm cast (LAC) as an immobilization method in pediatric distal forearm fractures. Patients and methods Between January 2016 and December 2019, a total of 186 pediatric patients (143 males, 43 females; mean age: 10.3±3 years; range, 4 to 15 years) with distal forearm fractures were retrospectively analyzed. The patients were divided into two groups according to the immobilization method: SSTS group (n=74) and LAC group (n=112). All patients were evaluated at the time of admission, immediately after the reduction, and at one, two, and four weeks. Sagittal and coronal plane angulations and translation percentages of the radius at each visit were calculated. Alterations in coronal angle, sagittal angle, sagittal translation and coronal translation were calculated by subtracting the measurements after reduction from the measurements at four weeks. Results Both groups were comparable in terms of demographic characteristics, fracture localization, and side of injured extremity. There was a statistically significant difference only in the sagittal angulations in the first (LAC: 4.7; SSTS: 6.5; p=0.009) and second week (LAC: 5.3; SSTS: 6.8; p=0.024). The rest of radiological measurements were comparable. In the LAC group, seven patients had re-intervention (three manipulations, four surgeries) and in the SSTS group, three patients had re-intervention (two manipulations, one surgery) (p=0.657). Conclusion Our study results suggest that SSTS and LAC are comparable in terms of radiological results and need for re-intervention as an immobilization method of pediatric distal forearm fractures.

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Comparison of the forearm rotation restriction capacities of four upper-extremity immobilization methods: there is no difference between single and double sugar tong splinting

Dastan,

Vahabi,

Coskunol

et al. 2024

J Orthop Surg Res

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Background The aim of this study was to compare the effects of four different immobilization methods [single sugar tong splint (SSTS), double sugar tong splint (DSTS), short arm cast (SAC), and long arm cast (LAC)] commonly used for restricting forearm rotation in the upper extremity. Methods Forty healthy volunteers were included in the study. Dominant extremities were used for measurements. Basal pronation and supination of the forearm were measured with a custom-made goniometer, and the total rotation arc was calculated without any immobilization. Next, the measurements were repeated with the SAC, LAC, SSTS and DSTS. Each measurement was compared to the baseline value, and the percentage of rotation restriction was calculated. Results The most superior restriction rates were observed for the LAC (p = 0.00). No statistically significant difference was detected between the SSTS and DSTS in terms of the restriction of supination, pronation or the rotation arc (p values, 1.00, 0.18, and 0.50, respectively). Statistically significant differences were not detected between the SAC and the SSTS in any of the three parameters (p values, 0.25; 1.00; 1.00, respectively). When the SAC and DSTS were compared, while there was no significant difference between the two methods in pronation (p = 0.50), a statistically significant difference was detected in supination (p = 0.01) and in the total rotation arc (p = 0.03). Conclusion The LAC provides superior results in restricting forearm rotation. The SAC and SSTS had similar effects on forearm rotation. The DSTS, which contains, in addition to the SSTS, a sugar tong portion above the elbow, does not provide additional rotational stability.

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Clinical and radiographic comparison of single-sugar-tong splint to long-arm cast immobilization for pediatric forearm fractures

Cited by 4 publications

References 10 publications

Functional outcome of long-arm cast versus double sugartong splint in acute paediatric distal forearm fractures: A randomised controlled trial

Functional outcome of long-arm cast versus double sugartong splint in acute paediatric distal forearm fractures: A randomised controlled trial

A comparison of two immobilization methods in the conservative treatment of pediatric distal forearm fractures: Long arm cast versus single sugar-tong splint

Comparison of the forearm rotation restriction capacities of four upper-extremity immobilization methods: there is no difference between single and double sugar tong splinting

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