[Usefulness of the cast index and padding index for the prognosis of pediatric forearm fractures].

BACKGROUND

The most frequent fractures in pediatric patients are those of the mid or distal shaft of the radius and ulna. Most of them can be treated with closed reduction and a brachio-palmar cast, but sometimes redisplacement or angulation occur within the first few weeks. Xray measurements to foresee these complications have been designed; this paper focuses on their certainty and usefulness.

METHODS

Twenty-four patients ages 2-14 years of age were included, all of them with closed fractures of the mid or distal shaft of the radius and ulna treated with reduction maneuvers under anesthesis and placement of an brachio-palmar cast. Measurements of the cast, padding and Canterbury indices were performed, which were compared with the clinical and X-ray results at three weeks. The sensitivity, specificity, and the positive and negative predictive value were calculated.

RESULTS

X-ray measurements had a sensitivity of 43%, a specificity of 88%, a positive predictive value of 60% and a negative predictive value of 79%.

CONCLUSION

The results of the measurements are consistent with the findings of other studies, which proves their usefulness; their use should therefore be encouraged to prevent complications like the displacement or angulation of forearm fractures in pediatric patients.