• Joost W Colaris, Max Reijman, Jan Hein Allema, L Ulas Biter, Rolf M Bloem, Cees P van de Ven, Mark R de Vries, Albert J H Kerver, and Jan A N Verhaar.
• Department of Orthopaedic Surgery, Erasmus Medical Center, Westzeedijk 361, Postbus 2040, 3000 CA, Rotterdam, The Netherlands, j.colaris@erasmusmc.nl.
• Arch Orthop Trauma Surg. 2013 Oct 1;133(10):1407-14.

IntroductionThis multicentre randomised controlled trial was designed to explore whether 6 weeks above-elbow cast (AEC) or 3 weeks AEC followed by 3 weeks below-elbow cast (BEC) cause similar limitation of pronation and supination in non-reduced diaphyseal both-bone forearm fractures in children.Materials And MethodsChildren were randomly allocated to 6 weeks AEC or to 3 weeks AEC followed by 3 weeks BEC. The primary outcome was limitation of pronation and supination after 6 months. The secondary outcomes were re-displacement of the fracture, complication rate, limitation of flexion and extension of wrist and elbow, cast comfort, cosmetics, complaints in daily life and assessment of radiographs.ResultsA group of 23 children was treated with 6 weeks AEC and 24 children with 3 weeks AEC and 3 weeks BEC. The follow-up rate was 98 % with a mean follow-up of 7.0 months. The mean limitation of pronation and supination was 23.3 ± 22.0 for children treated with AEC and 18.0 ± 16.9 for children treated with AEC and BEC. The other study outcomes were similar in both groups.ConclusionsEarly conversion to BEC is safe in the treatment of non-reduced diaphyseal both-bone forearm fractures in children.Level Of EvidenceMulticentre randomised controlled trial, Level II.

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