Cost analysis and performance in distal pediatric forearm fractures: is a short-arm cast superior to a sugar-tong splint?

J Pediatr Orthop B. 2017 Sep;26(5):424-428. doi: 10.1097/BPB.0000000000000382.


The aim of this study is to compare splint versus cast immobilization for maintaining alignment following closed reduction of distal 1/3 radius and both-bone forearm fractures. We performed a retrospective review of patient records between 5 and 14 years old with a distal 1/3 radius or radius and ulna fracture requiring reduction. A cost comparison was also performed using facility costs for materials. Reduction was maintained with acceptable alignment in most cases (94%). Although a sugar-tong splint slightly maintained fracture alignment better, this was not significant. Cost analysis favored initial placement of a short-arm cast ($23.59) versus a splint with later cast conversion ($26.95). Pediatric patients with a distal 1/3 radius and/or both-bone fracture requiring reduction maintain postreduction alignment irrespective of the immobilization method used, but initial placement of a short-arm cast is more cost-effective.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Casts, Surgical / economics*
  • Casts, Surgical / standards
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cost-Benefit Analysis / methods*
  • Female
  • Humans
  • Male
  • Radius Fractures / economics*
  • Radius Fractures / therapy
  • Splints / economics*
  • Splints / standards
  • Ulna Fractures / economics*
  • Ulna Fractures / therapy