Using removable splints instead of plaster casts for certain types of fracture makes life easier for young patients and also helps reduce pressure on busy emergency departments, according to Australian nurses who have tested this approach.
A trial in South Australia found using splints for buckle fractures in children was just as effective as casts and had benefits all round.
“This is a safe, quicker and more appealing treatment for young patients and their families”
Buckle or “torus” fractures are specific to children and generally occur when they fall with outstretched hands while taking part in sporting activities or using playground equipment.
Traditionally, treatment involves immobilising the injured limb with a plaster cast involving several follow-up trips to outpatients for X-rays, reviews and eventually to remove the cast. During the healing process the cast must be kept dry, making having a bath or shower difficult.
However, the nature of these fractures – where bones are squashed rather than snapped – means they can be treated with splints, said Cheryl Kimber, an orthopaedic nurse practitioner at the Flinders Medical Centre.
“Unlike many other fractures, a buckle fracture is stable making it an ideal candidate for a removable wrist support splint rather than a plaster cast,” she said. “This is a safe, quicker and more appealing treatment for young patients and their families.”
The study, carried out last year in the centre’s emergency department, saw 124 young patients diagnosed with buckle-type fractures. Of those 94 were given removable splints.
“Under usual circumstances, no further review is required with the new pathway,” said Ms Kimber, one of the study co-authors. “Patients simply use the splint for three to four weeks as advised, and then remove it. During the healing process, the splint can be removed while the child bathes or showers.”
The study found the technique was safe and saved money. The splints took much less time to apply in hospital, while families found them easier to cope with at home.
“Under the new pathway we now have less need for X-rays and plaster casts, and reduced outpatient reviews,” said Ms Kimber.
She added: “Today’s parents are very busy people, so knowing their child is getting the best possible treatment without having to disrupt school times and get time off work to make numerous trips to hospital is a fantastic outcome.”