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| |  Gore-Tex Casts are as Safe and Effective as Cotton Casts After Closed Reduction of Displaced Distal Radius Fractures in Children: Presented at AAP By Nora Steiner Mealy SAN FRANCISCO, CA -- October 30, 2007 -- Waterproof Gore-Tex-lined casts can safely be used in the immediate postreduction period for paediatric distal radius fractures, according to findings from a retrospective review presented here at the American Academy of Pediatrics 2007 National Conference and Exhibition (AAP). Forearm fractures comprise 45% of all fractures in children, with up to 84% of forearm fractures in children occurring in the distal third of the forearm. Closed reduction and cast immobilisation are the standard approach to treatment of displaced distal radius fractures in children. Gore-Tex casts are popular because children do not have to worry about them becoming wet when swimming or bathing. Traditional cotton-lined casts must be replaced if they become very wet because of the potential for children to develop itching and rash. Gore-Tex casts have long been used for nondisplaced or minimally displaced fractures, but up to now have never been shown to be safe for use immediately after closed reduction of displaced distal radius fractures, said principal investigator Alison Rozansky, MD, Orthopaedic Surgery, Akron General Medical Center, Akron, Ohio, United States. In their retrospectively study, Dr. Rozansky and colleagues reviewed 124 cases of distal radius fractures (72% had both distal radius and ulna fractures) that underwent closed reduction and application of a long-arm cast over a 2.5-year period. The cases included 55 children with Gore-Tex casts and 69 with traditional cotton-lined casts. No significant differences between the two groups were found regarding radial translation, angulation, or deviation at the time of injury, postreduction, or cast removal. Redisplacement rates -- as measured by the change in angulation, deviation, and translation from the time of reduction to cast removal -- also were not significantly different between the two groups. The average cast index was 0.89 and 0.87 for the Gore-Tex and traditional groups, respectively. No significant skin complications or cases of compartment syndrome were found in either group. The only disadvantage of Gore-Tex casts the study identified was that they cost about twice as much as traditional casts, although the cost of replacement of traditional casts if they become wet somewhat offsets the cost difference, the researchers noted. Dr. Rozansky acknowledged that in some communities the higher cost may preclude their routine use, but "the casts are so popular that many parents are willing to pay out-of-pocket for them," she said. Dr. Rozansky concluded that Gore-Tex casts can be used immediately after reduction in distal radius fractures in children, with no increased risk of displacement and with the advantages of added hygiene and activity benefits of a waterproof cast.
[Presentation title: Gore-Tex Vs. Traditional Cast Padding After Closed Reduction of Displaced Distal Radius Fractures in Children: A Retrospective Review. Abstract 431]
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