To Splint or not to Splint: Docs Disagree

Reported April 17, 2008

(Ivanhoe Newswire) -- Although splints and plaster casts both get the job done when it comes to minor wrist fractures in kids, there’s disagreement about which is the safer method.

A review on several studies on the topic has doctors on opposite sides of the Atlantic on opposing sides of the issue.

Alwyn Abraham, M.D., a consultant orthopedic pediatric surgeon at Leicester Royal Infirmary in Great Britain believes using casts for minor (buckle) fractures, which are common in children, is over-treatment. “Provided these are accurately diagnosed in an emergency department, these minor fractures can be treated with a removable splint,” Dr. Abraham was quoted as saying. “Removal can be done at home with no further follow-up.”
 

Leon Benson, M.D., spokesman for the American Academy of Orthopedic Surgeons and associate clinical professor of orthopedic surgery at Northwestern University’s Feinberg School of Medicine, agrees that splints work as well as casts for healing the injury. But he has concerns.

A plaster cast generally extends from the injury to the elbow and is usually worn for three weeks. It has to be removed by a doctor. Splints are also less expensive and restrictive, and parents preferred them in trials.

However, Dr. Benson maintains plaster is best. “My experience is that pain decreases dramatically more quickly with plaster casting than a splint and that adolescents in splints often remove them around their friends.” He goes on to say, “With a plaster cast, everyone can sleep at night. Nothing can make that cast fall off.” He also says that it would be “unfortunate” if splints became the method of treatment over plaster casts for economic reasons.

SOURCE: Cochrane Database of Systematic Reviews 2008, Issue 2