Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Orthopaedics
  • Orthopaedics News
  • Casting Alone Proven...

Casting Alone Proven as Effective as Surgery for Displaced Pediatric Elbow Fractures: Study

Written By : Dr Riya Dave |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2025-07-09T20:30:33+05:30  |  Updated On 9 July 2025 8:30 PM IST
Casting Alone Proven as Effective as Surgery for Displaced Pediatric Elbow Fractures: Study
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

In a new study published in JAMA casting has been found by researchers to be as effective as surgery in the treatment of displaced medial humeral epicondyle fractures in children. Displaced medial humeral epicondyle fractures are a frequent childhood injury. Long arm casting is traditionally used in the nonoperative treatment of these fractures. The study was conducted by Petra G. and colleagues.

The goal of this study was to compare the efficacy of surgical intervention through open reduction and internal fixation with casting in isolation for displaced medial humeral epicondyle fractures in children. The study, performed over four university hospitals in Finland between August 30, 2019, and August 22, 2023, incorporated a 12-month follow-up period to assess long-term functional outcome.

This noninferiority randomized clinical trial included 72 patients aged 7 to 16 years with displaced medial humeral epicondyle fractures (greater than 2 mm of displacement). Participants were randomly assigned to two groups:

  • Surgery Group: Had open reduction and internal fixation, followed by a long arm cast for 4 weeks.

  • Cast Group: Had a long arm cast without surgical reduction for 4 weeks.

The main outcome was assessed by the Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) score at 12 months on a scale of 0 (no disability) to 100 (severe disability). The noninferiority margin was established at 6.8 points. The trial was carried out with an intention-to-treat analysis so that all the participants were analyzed according to their initially allocated treatment group.

Key Findings

Functional Outcomes

  • Mean QDASH score at 12 months was 1.73 (95% CI, 0.65-2.81) for the cast group and 2.71 (95% CI, 0.52-4.90) for the surgery group, showing noninferiority of casting.

  • The difference in mean QDASH scores between groups was −0.98 points (95% CI, −2.95 to 0.98), which was below the prespecified noninferiority margin of 6.8 points.-

Cosmetic Outcomes:

  • The cast group had improved cosmetic results, with a statistically significant between-group difference of −8.9 points (95% CI, −16.6 to −1.2 points; P < .001) for the cosmetic visual analog scale.

Nonunion Rates:

  • Nonunion was present in 1 of 37 patients (2.7%) in the surgical group, versus 24 of 35 patients (68.6%) in the cast group.

  • In spite of the very high rate of nonunion in the cast group, this did not convert into poorer functional results at 12 months.

Demographic Data:

  • 72 patients were included in the study, of whom 43 (59.7%) were female.

  • The mean age of participants was 12.1 years (± 2.1 years), with an age range from 7.9 to 15.9 years.

Safety and Crossovers:

  • No patients in the cast group had to crossover to surgery during the study.

Casting was determined to be noninferior to surgical intervention using internal fixation of displaced medial humeral epicondyle fracture in children in terms of outcomes at 12 months. Additional studies perhaps may be necessary to evaluate outcome beyond 12 months, yet, nonoperative treatment is safe and effective treatment for this particular pediatric fracture category.

Reference:

Grahn P, Helenius I, Hämäläinen T, et al. Casting vs Surgical Treatment of Children With Medial Epicondyle Fractures: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(5):e258479. doi:10.1001/jamanetworkopen.2025.8479

JAMAMedial humeral epicondyle fracturepediatric fractureselbow fracturecastingsurgical fixationnonoperative treatmentfunctional outcomes
Source : JAMA
Dr Riya Dave
Dr Riya Dave

    Dr Riya Dave has completed dentistry from Gujarat University in 2022. She is a dentist and accomplished medical and scientific writer known for her commitment to bridging the gap between clinical expertise and accessible healthcare information. She has been actively involved in writing blogs related to health and wellness.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    Featured image representing orthopaedic care

    Modern Orthopaedic Care: How Is Technology Improving Movement and Recovery? - Dr Abhijit Lonari

    Aspirin in Primary Prevention of Stroke-Review of Evidence Through the Needs of Indian Clinical Settings

    Aspirin in Primary Prevention of Stroke-Review of Evidence Through the Needs of Indian Clinical...

    Dapagliflozin Shines in Post-TAVI Patients:DAPA-TAVI Trial Findings

    Dapagliflozin Shines in Post-TAVI Patients:DAPA-TAVI Trial Findings

    Identifying Candidates for Aspirin in Primary Prevention: Men Aged 40-50 with Hypertension, Dyslipidemia, and Familial ASCVD Risk

    Identifying Candidates for Aspirin in Primary Prevention: Men Aged 40-50 with Hypertension,...

    Featured image representing thinking

    Is Pharma Marketing Going Through "Thinking Recession"?

    View All

    Journal Club Today

    Micro labs to offer mucolytic solution for respiratory care with its recently launched Pulmucus range

    Micro labs to offer mucolytic solution for respiratory care with its recently launched Pulmucus...

    View All

    Health News Today

    Health Bulletin 9/July/ 2025

    Health Bulletin 9/July/ 2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok