A streamlined pathway for a common childhood fracture that uses removable splints rather than traditional plaster casts is leading to faster and simpler outcomes for families and hospitals. The pathway is designed to provide a more efficient treatment to patients, speed up treatment times in the ED and reduce demand on outpatient services at Flinders Medical Centre and Noarlunga Hospital in South Australia.
A buckle or “torus” fracture is specific to children, and generally occurs when they fall with outstretched hands while playing sport or climbing on playground equipment. Hundreds of children present each year to Emergency Departments (ED) with the injury in Adelaide, the South Australian capital.
Traditionally, treatment involves placing the injured limb in a plaster cast and then returning numerous times to the Outpatient Department for review, further castings, x-rays and then finally, removal of the cast. During the healing process the cast must remain dry, which makes bathing and showering difficult.
However, a study carried out in the Flinders Medical Centre ED last year found that removable splints were just as effective as plaster casts and had benefits for both patient and hospital.
Over an eight-month period in 2015, 540 paediatric patients were diagnosed with forearm fractures in the ED: 124 of which were buckle-type fractures. Of these 124 patients, 94 were placed in removable splints.
The study found that management of buckle fractures using the new pathway was safe, efficient and cost-saving. The removable splints were easier to manage at home, more appealing to patients and parents and were quicker to apply in the ED.
The Lead South Australia