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We investigated whether, in the management of stable paediatric fractures of the forearm, flexible casts that can be removed at home are as clinically effective, cost-effective and acceptable to both patient and parent as management using a cast conventionally removed in hospital. A single-centre randomised controlled trial was performed on 317 children with a mean age of 9.3 years (2 to 16). No significant differences were seen in the change in Childhood Health Assessment Questionnaire index score (p = 0.10) or EuroQol 5-Dimensions domain scores between the two groups one week after removal of the cast or the absolute scores at six months. There was a significantly lower overall median treatment cost in the group whose casts were removed at home (£150.88 (sem 1.90) vs £251.62 (sem 2.68); p < 0.001). No difference was seen in satisfaction between the two groups (p = 0.48).

Original publication

DOI

10.1302/0301-620x.95b12.31299

Type

Journal article

Journal

The bone & joint journal

Publication Date

12/2013

Volume

95-B

Pages

1714 - 1720

Addresses

Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Keywords

Humans, Radius Fractures, Ulna Fractures, Treatment Outcome, Activities of Daily Living, Device Removal, Fracture Fixation, Casts, Surgical, Quality of Life, Adolescent, Child, Child, Preschool, Home Care Services, Health Care Costs, Patient Satisfaction, Female, Male