[{"data":1,"prerenderedAt":173},["ShallowReactive",2],{"content-site-settings":3,"content-index-en":69},{"id":4,"extension":5,"meta":6,"stem":67,"__hash__":68},"dataFiles/data/site.json","json",{"en":7,"pl":62},{"siteDetails":8,"siteLogo":12,"cookieControl":17,"mainNav":21,"footerContent":35,"preNav":58,"stickyNav":59,"protectedLink":60},{"siteName":9,"siteUrl":10,"organisationName":11},"The NIHR Trauma, Orthopaedic and Emergency Trials in Children (TOTs)","https://tots.digitrial.com/","Alder Hey Children's Hospital",{"url":13,"alt":14,"width":15,"height":16},"tots-logo-1000w.png","Home",610,100,{"cookieModalTitle":18,"cookieModalText":19,"nonNecessaryCookiesUsed":20},"Cookies used on this site","This website only uses non-necessary cookies to remember where you are in the process and to learn about how people view the information. We do NOT use cookies that directly identify anyone. For the best experience please click Accept all below.",true,[22,25,29,32],{"title":23,"url":24},"Our Research","/our-research/",{"target":26,"external":26,"title":27,"url":28},false,"Patient Involvement","/patient-involvement/",{"title":30,"url":31},"Clinician Engagement","/clinician-engagement/",{"target":26,"external":26,"title":33,"url":34},"Contact","/contact/",{"footerLogo":36,"footerCol1":41,"footerCol2":42,"footerCol3":43,"additionalInfo":44,"footerLinks":45},{"url":37,"alt":38,"width":39,"height":40},"tots-footer-logo.svg","TOTs logo",310,140,"","TOTSresearch@liv.ac.uk","[Privacy policy](/privacy)  \n[Cookie policy](/cookie-policy)  \n[Accessibility statement](/accessibility)  \n[Site map](/site-map)","The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or any other body associated with the studies. The views expressed are those of the authors and are not intended to be representative of the views of the funder, sponsor or other participating organisations. The information contained in this website is for general information only and not intended as medical advice.",[46,49,52,55],{"title":47,"url":48},"Privacy policy","/privacy/",{"title":50,"url":51},"Cookie policy","/cookie-policy/",{"title":53,"url":54},"Accessibility statement","/accessibility/",{"title":56,"url":57},"Site map","/site-map/",[],[],{"url":61},"https://nuxt.com/",{"siteDetails":63,"footerContent":65},{"organisationName":64,"siteUrl":10},"Morph",{"footerLogo":66},{"url":37,"width":39,"height":40},"data/site","bpf2UH17H_kN88IrDNKcEtHtDsjRpu1B1BrYsO2LDJw",{"id":70,"title":71,"body":72,"description":72,"extension":5,"meta":73,"navigation":20,"path":169,"seo":170,"stem":171,"__hash__":172},"contentPages/pages/index.en.json","Home page",null,{"pageTitle":74,"pageMetadata":75,"page_content":77},"TOTs",{"htmlTitle":74,"htmlDesc":76},"The NIHR Trauma, Orthopaedic and Emergency Trials in Children (TOTs) group ",[78,92,143,153],{"type":79,"title":80,"sectionSettings":81,"text":84,"image":85,"settings":89},"page_header","# Introduction",{"theme":82,"sectionLabel":74,"customClass":83},"secondary","background-header-image-1","**Trauma, Orthopaedic and Emergency Trials in Children Collaborative**\n\nThe TOTs group is made up of surgeons from the British Society for Children's Orthopaedic Surgery and Emergency Medicine Clinicians from the Paediatric Emergency Research in the UK and Ireland (PERUKI) collaborative.",{"url":86,"alt":41,"width":87,"height":88},"tots-header-image-1.svg",1000,350,{"imgWidth":90,"imgPosition":91},"half-width","bottom",{"type":93,"sectionSettings":94,"settings":97,"cards":103},"text_and_cards",{"sectionLabel":95,"theme":96},"Links to other pages","light",{"alignCardContent":98,"customClass":99,"wholeClickable":20,"headerLevel":100,"cardTheme":101,"numberedCards":26,"maxCardsPerRow":102,"headerFontSize":102,"alignCards":98},"left","homepage-link-cards","2","none","4",[104,116,126,135],{"type":105,"image":106,"customClass":109,"title":110,"summary":111,"links":112},"card_image_text",{"url":107,"width":87,"height":108},"tots-card-image-1-1000w.png",645,"red","Our research","Find out about our ongoing and our completed studies that are impacting the care of children throughout the world.",[113],{"link":114},{"title":41,"url":115,"external":26,"target":26},"/our-research",{"type":105,"image":117,"title":119,"customClass":120,"summary":121,"links":122},{"url":118,"width":87,"height":108},"tots-card-image-2-1000w.png","Patient involvement","blue","We put children and their families at the centre of what we do – read more about it and find out how to get involved.",[123],{"link":124},{"title":41,"url":125},"/patient-involvement",{"type":105,"image":127,"title":129,"summary":130,"links":131},{"url":128,"width":87,"height":108},"tots-card-image-3-1000w.png","Clinician engagement","Discover ways to join our team of doctors and allied health professionals delivering world class research.",[132],{"link":133},{"url":134},"/clinician-engagement",{"type":105,"title":33,"image":136,"links":138,"summary":142},{"url":137,"width":87,"height":108},"tots-card-image-4-1000w.png",[139],{"link":140},{"title":41,"url":141},"/contact","Curious to find out more about what we do? Don't hesitate to contact us.",{"type":144,"sectionSettings":145,"text":147,"video":148,"settings":152},"text_and_video",{"textAlign":98,"sectionLabel":146},"SCIENCE case study","## SCIENCE case study\n\nFor years, surgeons around the world have disagreed on how best to treat a common children’s elbow fracture. Our team led a global study involving 334 children. The results are in - and the debate is over. Find out more here…",{"vimeoId":149,"videoTitle":150,"videoTranscript":151},"1106201868/0c801f9fdc","SCIENCE animation","A medial epicondyle fracture is a break on the inner side of the elbow where a small piece of bone gets damaged.\n\nEvery year, thousands of children around the world have this type of fracture.\n\nIn the past, doctors treated it in different ways.\n\nSome used a cast, allowing the bone to heal on its own. Others performed surgery, fixing the bone with screws or wires.\n\nHowever, families want to feel confident that surgery will really benefit their child before going ahead.\n\nTo find out if surgery was better than a cast researchers carried out the SCIENCE Study -\n\n short for Surgery or Cast for Injuries of the Epicondyle in Children’s Elbows.\n\nThe study involved 334 children aged 7 to 15 from the UK, Australia, and New Zealand.\n\nAll had a displaced medial epicondyle fracture.\n\nA quarter had a particularly severe injury, where the elbow was initially dislocated.\n\nThe SCIENCE Study was a randomised trial.\n\nThis means each child had an equal chance of receiving either treatment.\n\nThe decision was made by chance (at random) – rather than by families or doctors – to make the comparison fair and ensure the results are trustworthy.\n\nHalf of the children wore a cast for four weeks, while the other half had surgery to fix the bone with screws or wires.\n\nDuring their recovery, children and families were asked about pain, how well they could use their arm, how many hospital visits they had, and how much school they missed.\n\nThe results showed that both treatments worked just as well - surgery did not lead to better recovery.\n\nChildren had similar levels of pain, used their arms in the same way and got back to sport as quickly.\n\nHowever, using a cast meant fewer operations, fewer complications, fewer days of school missed, and lower costs for families and the health system.\n\nSo, for children with this kind of elbow fracture, wearing a cast is just as effective as surgery - and comes with fewer risks, more school and lower costs.",{"videoPosition":91,"videoAlign":98},{"type":154,"sectionSettings":155,"logos":158,"text":167,"maxLogosPerRow":168},"text_and_logos",{"textAlign":156,"sectionLabel":157},"center","In collaboration with",[159,162,165],{"url":160,"width":87,"height":161},"peruki-white-1000w.png",453,{"url":163,"width":87,"height":164},"bscos-white-1000w.png",454,{"url":166,"width":87,"height":161},"nihr-white-1000w.png","## In collaboration with",3,"/pages/index.en",{"title":71},"pages/index.en","Q4OGADHNy__wRckeEO9vZc1ZK7rrHgq_XM8j_afBrP4",1793114847104]