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      Does the location of short-arm cast univalve effect pressure of the three-point mould?

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          Forearm and distal radius fractures are among the most common fractures in children. Many fractures are definitively treated with closed reduction and casting, however, the risk for re-displacement is high (7% to 39%). Proper cast application and the three-point moulding technique are modifiable factors that improve the ability of a cast to maintain the fracture reduction. Many providers univalve the cast to accommodate swelling. This study describes how the location of the univalve cut impacts the pressure at three-point mould sites for a typical dorsally displaced distal radius fracture.


          We placed nine force-sensing resistors on an arm model to collect pressure data at the three-point mould sites. Sensory inputs were sampled at 15 Hz. Cast padding and a three-point moulded short arm fibreglass cast was applied. The cast was then univalved on the dorsal, volar, radial or ulnar aspect. Pressure recordings were obtained throughout the procedure.


          A total of 24 casts were analyzed. Casts univalved in the sagittal plane (dorsal or volar surface) retained up to 16% more pressure across the three moulding sites compared with casts univalved in the coronal plane (radial or ulnar border).


          Maintaining pressure at the three-point mould prevents loss of reduction at the fracture site. This study shows that univalving the cast dorsally or volarly results in less pressure loss at moulding sites. This should improve the chances of maintaining fracture reductions when compared with radial or ulnar cuts in the cast. Sagittal plane univalving of forearm casts is recommended.

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          Most cited references 20

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          Epidemiology of children's fractures.

           L. Landin (1997)
          Fractures constitute 10% to 25% of all pediatric injuries and are more common in boys than in girls, and after age 13 or 14 years are twice as common. The results from an epidemiologic study in Malmö indicate that a child's risk of sustaining a fracture is 42% in boys and 27% in girls from birth to age 16 years. Fractures of the distal end of the radius are the most common injury, followed by fractures of the phalanges of the hand. From 1950 to 1979 there was a twofold increase in the risk of fracture, due to an increase in light-energy trauma, mainly sporting activities. Since the end of the 1970s there has been no further increase in the fracture risk. The data also indicate that preventive measures have been effective in decreasing severe accidents.
            • Record: found
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            Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States.

            Fractures in children are an important public health issue and a frequent cause of emergency room visits. The purpose of this descriptive epidemiological study was to identify the most frequent pediatric fractures per 1000 population at risk in the United States using the 2010 National Electronic Injury Surveillance System (NEISS) database and 2010 US Census information.
              • Record: found
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              Pediatric fractures of the forearm.

              Forearm fractures are common injuries in childhood. There are a number of important principles that should be followed to achieve the ideal goal of fracture healing without deformity or dysfunction. I will review the general principles, classifications, diagnosis, treatment, and complications of pediatric forearm fractures, including some specific injuries such as Monteggia fractures, Galeazzi injuries, and open fractures. The basic principle is to accurately align the fracture fragments and to maintain this position until the fracture is united. Forearm fractures in children can be treated differently from adult fractures because of continuing growth in both bones (radius and ulna) after the fracture has healed. As long as the physes are open, remodeling can occur. However, generally it is thought that rotational deformity does not remodel. Undisplaced fractures may be treated in a cast until the fracture site is no longer painful. Most displaced fractures of the forearm are best maintained in a long arm cast. However, redisplacement occurs in 7 to 13% of cases, usually within 2 weeks of injury. Unstable metaphyseal fractures should be percutaneously pinned. Unstable diaphyseal fractures can be stabilized by intramedullary fixation of the radius and ulna. If none of these techniques is helpful, plate and screw fixation is the best choice.

                Author and article information

                J Child Orthop
                J Child Orthop
                Journal of Children's Orthopaedics
                The British Editorial Society of Bone & Joint Surgery (London )
                1 June 2020
                : 14
                : 3
                : 236-240
                [1 ] org-divisionDepartment of Orthopaedic Surgery, Stanford University , Redwood City, California, USA
                [2 ] org-divisionLucile Packard Children’s Hospital , Palo Alto, California, USA
                [3 ] org-divisionDepartment of General Surgery, Stanford University , Palo Alto, California, USA
                Author notes
                Correspondence should be sent to Steven Frick, Stanford Children’s Health, Lucile Packard Children’s Hospital , 300 Pasteur Drive, Edwards Bldg R107, Stanford, CA 94305, USA. Email: sfrick01@
                Copyright © 2020, The author(s)

                Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                Basic Science
                childrens-orthopaedics, Children’s Orthopaedics


                pressure loss, cast, force sensor, three-point mould, univalve


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