Spica Casting for Pediatric Femoral Fractures

• Published in: Journal of bone and joint surgery. American volume 2012, Vol.94 (14), p.1259-1264
• Main Authors: Leu, Dirk, MD, Sargent, M. Catherine, MD, Ain, Michael C., MD, Tis, John E., MD, Sponseller, Paul D., MD, Leet, Arabella I., MD
• Format: Article
• Language: English
• Subjects: Orthopedics
• ISSN: 0021-9355
• DOI: 10.1016/S0021-9355(12)70290-4

Background At many centers, double-leg spica casting is the treatment of choice for diaphyseal femoral fractures in children two to six years old. We hypothesized that such patients can be effectively treated with single-leg spica casting and that such treatment would result in easier care and better patient function during treatment. Methods In a prospective, randomized controlled study, fifty-two patients two to six years old with a diaphyseal femoral fracture were randomly assigned to be treated immediately (after consent was obtained) with a single-leg (twenty-four patients) or double-leg (twenty-eight patients) spica cast. Serial radiographs were evaluated for maintenance of fracture reduction with respect to limb length, varus/valgus angulation, and procurvatum/recurvatum angulation. After cast removal, the performance version of the Activities Scale for Kids questionnaire and a custom-written survey were administered to the parents so that they could evaluate the ease of care and function of the children during treatment. Means were compared between treatment groups with use of Student t tests. P values of