Cast wedging: A systematic review of the present evidence

• Published in: Journal of children's orthopaedics Vol. 11; no. 5; pp. 398 - 403
• Main Authors: Gaukel, S., Leu, S., Fink, L., Skovgaard, S. R., Ramseier, L. E., Vuille-dit-Bille, R. N.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-10-2017; Sage Publications Ltd; The British Editorial Society of Bone and Joint Surgery
• Subjects: Failure; Fractures; Meta-analysis; Orthopedics; Patients; Pediatrics; Systematic Review; long-bone fracture; Cast wedging; systematic review; children
• ISSN: 1863-2521; 1863-2548
• DOI: 10.1302/1863-2548.11.170109

Purpose
The objective of this systematic review was to summarise the outcome after cast wedging due to loss of angulation in conservative fracture treatment of children's fractures.
Methods
Electronic searches were performed using MEDLINE, PubMed, OVID, CENTRAL and EMBASE without language restrictions.
Results
Three studies comprising 316 patients (210 radius, 52 forearm/both bone forearm fractures and 54 tibia fractures) were included in the present analysis. Cast wedge failures occurred in 14 of 316 (4.4%) patients. Three patients (0.9%) needed surgical fixation and 11 patients (3.4%) ended up with a healed deformity. Furthermore, eight of 316 (1.8%) patients needed remanipulation and cast change.
Conclusion
Cast wedging reflects a reliable treatment option for secondary displaced long-bone paediatric fractures.