Importance of calculating various casting indices in predicting radiological outcomes of paediatric forearm fractures


  • Pyntngen Kharbamon Consultant Orthopedic Surgeon, Woodland Hospital, Shillong, Meghalaya, India
  • Binoti A. Sheth Department of Orthopaedics, Lok Manya Tilak Medical College and Hospital, Sion, Mumbai, Maharashtra, India
  • Pankaj Pawar Department of Orthopaedics, Lok Manya Tilak Medical College and Hospital, Sion, Mumbai, Maharashtra, India
  • Siddhart Parekh Consultant Orthopedic Surgeon, Unity Hospital, Vasad, Gujarat, India
  • Rishabh Jaiswal Department of Orthopaedics, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India
  • Umesh Kanade Department of Orthopedics, Bharti Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India



Casting indices, Paediatric forearm fracture, Prognosis


Background: The present study is aimed at determining the importance of various casting indices in predicting the outcome of paediatric forearm fractures treated with closed reduction and plaster application in our department.

Methods: Thirty children, aged 5 to 15 years, with closed forearm fractures not requiring surgical fixation were included to assess their casting indices and radiological outcomes using X-rays. After satisfactory casting, patients were followed up weekly till 6 weeks with anteroposterior (AP) and lateral X-ray.

Results: Acceptable reduction was achieved in 26 cases, while re-manipulation was done in 4 cases. Cast Index ranged from 0.80±0.09 at first week to 0.78±0.09 at 6 weeks, Padding Index was 0.30±0.04 at first week and increased to 0.31±0.03 at 6 weeks, Canterbury Index was 1.07±0.24 at first week and 1.07±0.78 at 6 weeks, Gap Index 0.15±0.02 remained the same throughout, and Three Point Index changed from 0.81±0.08 at first week to 0.77±0.18 six weeks. Radial bow of children showed no significant change at various time points of assessment. Rotational mal-alignment was observed in 5 patients, one had a 0.5 cm radial overlap, while none had an ulnar overlap. Radial angulation was observed in five and six children on AP and lateral X-ray respectively. Ulnar angulation was seen in two and one child on AP and lateral X-ray respectively.

Conclusions: Continued use of these casting indices to assess paediatric forearm cast adequacy is supported by this study.


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Original Research Articles