Evaluation Of Cast Index In Predicting The Outcome Of Pediatric Forearm Fractures

Abstract

Background: Pediatric forearm fractures of radius ulna account for 40% of all pediatric fracture. Closed reduction followed by application of well molded plaster cast is the standard treatment for these fractures, which can be complicated by re-displacement inside the cast, which further needs re-manipulation or surgery. We assessed the rate if re-displacement in paediatric forearm fractures treated by cast by calculating the cast index. Material & Methods: 30 patients with fractures of both radius ulna were treated with close reduction and cast application and Cast Index was calculated in immediate post reduction and subsequent radiographs at 2, 4 and 6 weeks. These were evaluated for re-displacement and their relation with cast index. Results: The mean CI was found to be 0.858. Three patients had re-displacement which required re-manipulation, the mean CI in these re-displacement group was 0.92. Mean CI was found to be higher in proximal third fractures however it did not correspond to increased incidence of re-displacement. Conclusion: Our study provides sufficient association of cast index in predicting the outcome of pediatric forearm fractures. Higher CI in proximal third fracture didn’t correspond to increased incidence of re-displacement.