The Effect of Combined Sugar-Tong and Long-Arm Splinting on Fracture Displacement in Children with Complete Forearm Fractures
Volume 6, Issue 1, Winter 2027, Pages 109-117
https://doi.org/10.5281/zenodo.21924228
Alireza Aghili, Parham Maroufi
Abstract Introduction: Pediatric complete forearm fractures may redisplace after closed reduction, potentially causing functional impairment and requiring repeat intervention. Although long-arm and sugar-tong splints can restrict motion and accommodate swelling, the effectiveness of their combined use remains uncertain. This study aimed to evaluate the effect of combined sugar-tong and long-arm splinting on fracture displacement in children with complete forearm fractures.
Material and methods: This randomized clinical trial at Shohada Hospital, Tabriz, evaluated 50 children with complete forearm fractures requiring closed reduction (25 per group, calculated via the two-independent-means formula). Participants were randomly assigned to combined sugar-tong and long-arm splinting or standard long-arm splinting alone. Serial radiographs were obtained from post-reduction through early follow-up to evaluate changes in fracture angulation and translation between the two immobilization methods.
Results: The combined splint group maintained better alignment than the standard splint group, with lower AP angulation, lateral angulation, translation, and shortening at follow-up (week 1 and 2, all P≤0.001); it also had fewer losses of reduction (8.0% vs. 36.0%,P=0.014) and remanipulations (4.0% vs. 24.0%, P=0.037), while parental satisfaction was higher (8.6±1.1 vs. 6.8±1.5, P<0.001).
Conclusion: Combined sugar-tong and long-arm splinting was more effective than standard splinting in preserving reduction and preventing secondary displacement in children with complete forearm fractures, without increasing complications. This simple immobilization strategy may improve early fracture stability and reduce the need for repeat intervention.