Prospective Evaluation of Cast Bivalving for Pediatric Distal Radius Fractures

Pediatric patients with distal radius fractures are most commonly treated non-operatively with fracture reduction and cast immobilization. In order to prevent complications from increased swelling after the injury (or fracture manipulation) casts may be split along their length to relieve pressure. However, this can compromise the casts' structural integrity, predisposing fractures to loss of reduction. The goal of this study was to investigate if cast bivalving, or splitting the cast longitudinally on both sides, resulted in any immediate change to bony alignment and to assess if bivalving effected cast parameters associated with loss of reduction.

Inclusion Criteria: * Guardian must be present * Able/eligible to complete follow-up * Initial injury within 72 hours * Distal Radius fracture with or without distal ulna fracture * Requiring non-operative management with molded cast Exclusion Criteria: * Open fractures * Re-fractures * Pathologic fractures * Fractures associated with neurovascular injury * Poly trauma incident * Intubated patients or unable to verbalize symptoms of pain * Preexisting medical history that effects musculoskeletal health