Cast wedging: A systematic review of the present evidence

Abstract

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.