Background: Various techniques of non-operative management of pediatric forearm fractures have proven to be successful in avoiding surgical risk and obtaining acceptable outcomes for patients. However, the ability of plaster versus fiberglass splint material to maintain reduction of these fractures has not been compared. Our goal was to determine whether splint material affects the success of non-operative management of pediatric forearm fractures. Methods: All patients aged 0-18 years with a traumatic forearm fracture requiring reduction were enrolled prospectively and randomized to fiberglass (Ortho-Glass®, Essity Medical Solutions, Charlotte, NC) or plaster sugartong splints. A total of 230 patients met inclusion criteria: 90 randomized to plaster and 140 to fiberglass. Patients were stratified based on location of fracture: distal radius fractures (DRF), middle both bone forearm fractures (BBFFx), and proximal BBFFx. Radiographic outcomes including residual deformity and clinical outcomes including conversion to surgery were evaluated in all patients. Statistical analysis was performed with t-test, Wilcoxon rank sum, Chi-Square, or Fisher's exact tests where applicable. Results: Radiographic and clinical outcomes were similar between fiberglass and plaster splints. Overall, only 2.6% of patients required conversion to surgery, 1.1% of the plaster cohort and 3.6% of the fiberglass cohort (p=0.41). No patients required re-reduction with sedation. At final follow-up, 32.5% of middle or proximal BBFFx and 1.3% of DRF healed in "unacceptable" alignment according to classically described guidelines. Conclusions: There is no difference in the effectiveness of fiberglass or plaster sugartong splints for initial immobilization of pediatric BBFFx and DRF. Rates of conversion to surgery were lower in both groups than previously described. However, there was a trend toward treating "unacceptably" aligned forearm fractures non-operatively and more research is indicated to determine the long-term clinical significance. Level of Evidence: Level I Key Concepts•Splint material is not a contributing factor to maintaining reduction of distal radius and both bone forearm fractures in children.•Closed reduction and sugartong splinting of pediatric distal radius and both bone forearm fractures provide favorable outcomes with low surgical conversion rate.

© 2023 JPOSNA. Published by Elsevier on behalf of the Pediatric Orthopaedic Society of North America.

背景：各种非手术治疗儿童前臂骨折的技术已被证明可以在避免手术风险的同时为患者获得可接受的治疗效果。然而，石膏与玻璃纤维夹板材料在保持这些骨折复位方面的有效性尚未进行比较。我们的目标是确定夹板材料是否会影响儿童前臂骨折非手术治疗的成功率。方法：所有0-18岁年龄组需要复位的创伤性前臂骨折患者均被前瞻性地纳入研究，并随机分配到玻璃纤维（Ortho-Glass®，Essity Medical Solutions，美国北卡罗来纳州夏洛特）或石膏夹板。共有230名患者符合入选标准：90名被分配到石膏组，140名被分配到玻璃纤维组。根据骨折位置对患者进行分层：远端桡骨骨折（DRF）、中段双骨前臂骨折（BBFFx）和近端BBFFx。放射学结果包括残留畸形以及临床结果包括转换为手术的评估均在所有患者身上进行了评价。适用时，统计分析使用t检验、Wilcoxon秩和检验、卡方检验或费希尔精确检验。结果：玻璃纤维夹板与石膏夹板之间的放射学和临床结果相似。总体而言，只有2.6%的患者需要转为手术治疗，其中石膏组1.1%，玻璃纤维组3.6%（p=0.41）。没有患者在镇静下重新复位。最终随访时，中段或近端BBFFx中有32.5%和DRF中有1.3%的骨折“不理想”对齐，根据经典描述的标准。结论：对于初始固定儿童双骨前臂骨折（BBFFx）和远端桡骨骨折（DRF），玻璃纤维或石膏糖夹板在有效性方面没有差异。两组转为手术的比例均低于先前报道的水平。然而，在非手术治疗“不理想”对齐的前臂骨折方面存在趋势，需要进一步研究以确定其长期临床意义。证据级别：I级 关键概念 •夹板材料不是维持儿童远端桡骨和双骨前臂骨折复位的因素。 •闭合复位并用糖夹板固定儿童远端桡骨和双骨前臂骨折可获得良好的治疗效果，并且手术转换率低。

© 2023 JPOSNA。由Elsevier代表北美小儿骨科学会出版。