Initial Management of Pediatric Plastic Fractures

Immobilization Techniques

• The American Academy of Orthopaedic Surgeons recommends immobilization with a posterior splint (back-slab) for pediatric plastic fractures, as it provides better pain relief during the first two weeks after injury, with moderate-strength evidence supporting this recommendation 1, 2
• Posterior splinting is preferred over collar and cuff immobilization, as studies show inferior pain control with the latter, based on moderate quality studies 1

Follow-up Care

• The American Academy of Orthopaedic Surgeons does not provide specific recommendations on optimal time for removal of immobilization, need for supervised physical or occupational therapy, or optimal timing for allowing unrestricted activity, highlighting the need for further guidance 3, 4