Paediatric Shaft Femur Fractures Treated By Early Spica Cast.

Abstract

Objective: To find out the advantages of early spica cast as a treatment for isolated femoral shaft fracture in children.Study design: Descriptive studyPlace and duration of study: Department of orthopaedics. Government medical college Jammu.Patients and Methods: 31 patients with a mean age of 3.2 years range (2months -10 years) with closed isolated femoral shaft fractures were included in the study. Patients having compound fractures and those with associated injuries were excluded from the study .spica cast was applied under general anaesthesia after prelimnary skin traction, however immediate spica was given in children less than one year and those who had less than 2cm shortening on telescopy. Follow up was done in OPD after 1,4,6,10,12 weeks with check x-rays taken at every visit.Results: 31 children were included in the study, with a mean age of 3.2 years range (2months to 10 yrs.). Average duration of skin traction was 11.8 days range (0-21) days. Average duration of hospital stay was 13 days range (2-22) days. Average time for fracture union was 5.9 weeks range (4-12) weeks. At final followup 1 patient had LLD of 1.5 cm, 3 had LLD of 1 cm, 6 had LLD of 0.5cm, while 21 children had no LLD. None of the patients had short legged gait. None of the patients needed cast removal for any cast related complication.Conclusion: Traction followed by spica cast is a safe and effective method for closed fracture shaft of femur with very low risk of complication and should be recommended in children in less than 10 years of age.