Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials
<h3>Objectives:</h3><p dir="ltr">Distal forearm fractures are the most common pediatric fractures. This study aimed to investigate the effectiveness of below-elbow cast treatment for displaced distal forearm fractures in children compared to above-elbow cast through meta-...
محفوظ في:
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| مؤلفون آخرون: | , , |
| منشور في: |
2023
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| الموضوعات: | |
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إضافة وسم
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| _version_ | 1864513526915137536 |
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| author | Osama Z Alzobi (17993839) |
| author2 | Ashraf T Hantouly (17993842) Mohamed Kenawey (17993845) Talal Ibrahim (112568) |
| author2_role | author author author |
| author_facet | Osama Z Alzobi (17993839) Ashraf T Hantouly (17993842) Mohamed Kenawey (17993845) Talal Ibrahim (112568) |
| author_role | author |
| dc.creator.none.fl_str_mv | Osama Z Alzobi (17993839) Ashraf T Hantouly (17993842) Mohamed Kenawey (17993845) Talal Ibrahim (112568) |
| dc.date.none.fl_str_mv | 2023-06-01T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1177/18632521231162621 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Below-_versus_above-elbow_cast_treatment_of_displaced_distal_forearm_fractures_in_children_A_systematic_review_and_meta-analysis_of_randomized_controlled_trials/25250068 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Paediatrics Displaced distal forearm fractures pediatrics cast randomized controlled trial meta-analysis |
| dc.title.none.fl_str_mv | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Objectives:</h3><p dir="ltr">Distal forearm fractures are the most common pediatric fractures. This study aimed to investigate the effectiveness of below-elbow cast treatment for displaced distal forearm fractures in children compared to above-elbow cast through meta-analysis of randomized controlled trials.</p><h3>Methods:</h3><p dir="ltr">Several databases from January 1, 2000 until October 1, 2021 were searched for randomized controlled trials that assessed below versus above-elbow cast treatment of displaced distal forearm fractures in pediatric patients. The main meta-analysis comparison was based on the relative risk of loss of fracture reduction between children undergoing below versus above-elbow cast treatment. Other outcome measures including re-manipulation and cast-related complications were also investigated.</p><h3>Results:</h3><p dir="ltr">Nine studies were eligible of the 156 articles identified, with a total of 1049 children. Analysis was undertaken for all included studies with a sensitivity analysis conducted for studies with high quality. In the sensitivity analysis, the relative risks of loss of fracture reduction (relative risk = 0.6, 95% confidence interval = 0.38, 0.96) and re-manipulation (relative risk = 0.3, 95% confidence interval = 0.19, 0.48) between the below and above-elbow cast groups were in favor of below-elbow cast and statistically significant. Cast-related complications were in favor of below-elbow cast but did not attain statistical significance (relative risk = 0.45, 95% confidence interval = 0.05, 3.99). Loss of fracture reduction was noted in 28.9% of patients treated with above-elbow cast and 21.5% in below-elbow cast. Re-manipulation was attempted in 48.1% versus 53.8% of children who lost fracture reduction in the below-elbow cast and above-elbow cast groups, respectively.</p><h3>Conclusion:</h3><p dir="ltr">Below-elbow cast treatment was favored, with statistical significance, in terms of loss of fracture reduction and re-manipulation, and was not associated with a higher risk of cast-related complications. The accumulative evidence currently does not support above-elbow cast treatment and below-elbow cast treatment should be the mainstay for displaced distal forearm fractures in children.</p><h3>Level of evidence:</h3><p dir="ltr">Level I, meta-analysis of therapeutic level I studies.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Children's Orthopaedics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1177/18632521231162621" target="_blank">https://dx.doi.org/10.1177/18632521231162621</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_0bd017d387e2fa7b7ef5e17cc0f04a5c |
| identifier_str_mv | 10.1177/18632521231162621 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/25250068 |
| publishDate | 2023 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trialsOsama Z Alzobi (17993839)Ashraf T Hantouly (17993842)Mohamed Kenawey (17993845)Talal Ibrahim (112568)Biomedical and clinical sciencesClinical sciencesPaediatricsDisplaced distal forearm fracturespediatricscastrandomized controlled trialmeta-analysis<h3>Objectives:</h3><p dir="ltr">Distal forearm fractures are the most common pediatric fractures. This study aimed to investigate the effectiveness of below-elbow cast treatment for displaced distal forearm fractures in children compared to above-elbow cast through meta-analysis of randomized controlled trials.</p><h3>Methods:</h3><p dir="ltr">Several databases from January 1, 2000 until October 1, 2021 were searched for randomized controlled trials that assessed below versus above-elbow cast treatment of displaced distal forearm fractures in pediatric patients. The main meta-analysis comparison was based on the relative risk of loss of fracture reduction between children undergoing below versus above-elbow cast treatment. Other outcome measures including re-manipulation and cast-related complications were also investigated.</p><h3>Results:</h3><p dir="ltr">Nine studies were eligible of the 156 articles identified, with a total of 1049 children. Analysis was undertaken for all included studies with a sensitivity analysis conducted for studies with high quality. In the sensitivity analysis, the relative risks of loss of fracture reduction (relative risk = 0.6, 95% confidence interval = 0.38, 0.96) and re-manipulation (relative risk = 0.3, 95% confidence interval = 0.19, 0.48) between the below and above-elbow cast groups were in favor of below-elbow cast and statistically significant. Cast-related complications were in favor of below-elbow cast but did not attain statistical significance (relative risk = 0.45, 95% confidence interval = 0.05, 3.99). Loss of fracture reduction was noted in 28.9% of patients treated with above-elbow cast and 21.5% in below-elbow cast. Re-manipulation was attempted in 48.1% versus 53.8% of children who lost fracture reduction in the below-elbow cast and above-elbow cast groups, respectively.</p><h3>Conclusion:</h3><p dir="ltr">Below-elbow cast treatment was favored, with statistical significance, in terms of loss of fracture reduction and re-manipulation, and was not associated with a higher risk of cast-related complications. The accumulative evidence currently does not support above-elbow cast treatment and below-elbow cast treatment should be the mainstay for displaced distal forearm fractures in children.</p><h3>Level of evidence:</h3><p dir="ltr">Level I, meta-analysis of therapeutic level I studies.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Children's Orthopaedics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1177/18632521231162621" target="_blank">https://dx.doi.org/10.1177/18632521231162621</a></p>2023-06-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1177/18632521231162621https://figshare.com/articles/journal_contribution/Below-_versus_above-elbow_cast_treatment_of_displaced_distal_forearm_fractures_in_children_A_systematic_review_and_meta-analysis_of_randomized_controlled_trials/25250068CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/252500682023-06-01T00:00:00Z |
| spellingShingle | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials Osama Z Alzobi (17993839) Biomedical and clinical sciences Clinical sciences Paediatrics Displaced distal forearm fractures pediatrics cast randomized controlled trial meta-analysis |
| status_str | publishedVersion |
| title | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials |
| title_full | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials |
| title_short | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials |
| title_sort | Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials |
| topic | Biomedical and clinical sciences Clinical sciences Paediatrics Displaced distal forearm fractures pediatrics cast randomized controlled trial meta-analysis |