Question and Methods: This large, multicentre, pragmatic RCT aimed to show equivalence between treating pediatric buckle fractures of the distal radius with soft bandage versus rigid immobilisation.
Findings: With 965 participants, equivalence demonstrated for primary outcome of pain at day 3 (average pain scores 3.21 vs 3.14, adjusted difference -0.10 [95% CI -0.37 to 0.17]). Mild, transient increased analgesia use and decreased parental satisfaction in intervention group on day 1.
Limitations: An inability to blind participants, a clear patient/parent preference for rigid immobilisation, and a high cross-over rate between intervention groups.
Interpretation: Supports offering a soft bandage for distal radius buckle fractures instead of the usual practice pattern of rigid immobilization up to 3 weeks.
JC Supervisor: Dr. Debra Eagles
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.
Dr. Debra Eagles obtained her degree and residency training in Emergency Medicine from the University of Ottawa. She has a special interest in altered mental status, both dementia and delirium, frailty, and geriatric trauma.