![]() 15 Given the variety of splinting and immobilization devices Discussion A soft cast is a semirigid waterproof cast made from synthetic casting material that allows for micro-movement and bathing while worn and can be cut off or unwrapped at home. The comprehensive search of the literature revealed a number of studies published within the past 10 years that compared the treatment of pediatric TFs using traditional casting to a plaster splint, plaster volar backslab, prefabricated splint, and a soft cast. Search terms included “distal radius fracture treatment,” “torus fracture treatment pediatrics,” “buckle fracture treatment pediatrics,” “torus fracture pediatrics,” “splint versus cast treatment torus pediatric,” and “splint versus cast treatment radius fracture pediatric.” The Medical Subject Heading term first used was “fracture” and was further narrowed down to “radius Results 7 These children often MethodsĪ comprehensive literature review was performed using the following databases: PubMed, CINAHL, Scopus, and Google Scholar. 5, 6 TFs are the most common of forearm fractures, accounting for half of distal forearm fractures in school-age children. ![]() TFs differ from greenstick fractures in that they occur when the cortex of the bone is compressed in such a fashion that one side remains intact and the other “buckles” without interrupting the cortex, whereas greenstick fractures occur when one side remains intact but there is an interruption in the cortex and periosteum of the other side of the bone. The purpose of this literature review is to answer the following clinical question that follows the PICO (Patient, Intervention, Comparison, Outcome) format to provide nurse practitioners with the latest evidence on pediatric torus fractures (TFs) to inform their delivery of care: In school-age children with a TF of the distal forearm, does treatment with a removable immobilization device (RID) reduce complications and increase parent satisfaction compared with treatment with a rigid cast (RC)? 2 Prompt and appropriate treatment is necessary to reduce or stabilize fractures to prevent complications such as delayed or deformed healing, increased pain, and refracture or increase in angulation due to the weakness and compromised bone integrity after a fracture. The higher incidence of fractures in school-age children is attributed to their active involvement in sports activities during childhood. ![]() 2, 3 The American Academy of Orthopaedic Surgeons (AAOS) 4 reported that forearm fractures are the most common fracture in pediatrics, accounting for 40% of all fractures during childhood. 2 Fractures are the most common reason for pediatric emergency department visits, with fracture rates higher in males than females at an average age of 10.4 and 9.3, respectively. 1 One in 4 children in the United States requires medical attention for an injury each year, with fracture rates reportedly as high as 12 to 36 per every 1,000 children. Fractures, as undesirable as they are, are deemed a “normal” part of childhood and are often caused by falls, sports injuries, and motor vehicle accidents. ![]()
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