The treatment of stable paediatric forearm fractures using a cast that may be removed at home: comparison with traditional management in a randomised controlled trial

Bone Joint J. 2013 Dec;95-B(12):1714-20. doi: 10.1302/0301-620X.95B12.31299.


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).

Keywords: Cost analysis; Functional outcome; Home removable cast; Paediatric forearm fracture; RCT; Randomised controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Casts, Surgical* / economics
  • Child
  • Child, Preschool
  • Device Removal
  • Female
  • Fracture Fixation / economics
  • Fracture Fixation / instrumentation*
  • Fracture Fixation / methods
  • Health Care Costs / statistics & numerical data
  • Home Care Services / economics
  • Humans
  • Male
  • Patient Satisfaction
  • Quality of Life
  • Radius Fractures / economics
  • Radius Fractures / surgery*
  • Treatment Outcome
  • Ulna Fractures / economics
  • Ulna Fractures / surgery*