Background and objectives In July 2013, the Paediatric Emergency Department (ED) of a UK District General Hospital ED seeing approximately 30000 children aged under 16 years of age per year in the ED, began managing children diagnosed with a torus fracture of the distal radius with a wrist splint and written self-care information, rather than a wrist splint and hospital-based fracture clinic follow-up. This study assessed the impact of this change in practice.
Methods A 14 month retrospective review of all children diagnosed with a torus fracture of the distal radius was conducted. Referrals to fracture clinic and the number of children re-attending the ED with complications related to the initial injury (such as pain or splint problem) were analysed. All children had appropriate wrist immobilisation.
Results 197 children were diagnosed with a torus fracture of the distal radius. 161 (median 14/month) attended pre-change in practice and 36 (median 12/month) attended post-change.
131 (66%) were referred to the fracture clinic, (126 (78%) pre-change in practice and 5 (14%) post-change). The remainder were discharged with written self-care information.
In the one month following initial attendance, 34 (21%) re-attended the ED pre-change in practice and 3 (8%) post-change.
Conclusions Children with a torus fracture of the distal radius can be appropriately managed with a wrist splint and written self-care information, rather than by hospital fracture clinic follow-up. This more efficiently uses healthcare resources, reduces re-attendances during the month following initial injury and reduces social inconvenience for children and their families.