Outcome of early versus delayed spica cast treatment of closed femoral shaft fracture in children of age 6 months to 10 years

Abstract

Background: Femoral shaft fractures are among the commonest fractures of the lower extremity in children and commonly require hospital admission.There are various modalities of treatments both operative and non-operative. The aim of treatment is to secure union, in good alignment with length restored and early rehabilitation Objective: To compare the results ofearly spica cast and skin traction followed by spicacast in the treatment of femoral shaft fractures in children (6 months to 10 years). Method: A total of 64 patients with fracture shaft femurof either sex aged 6 months-10 years with closed, isolated diaphyseal femur fracture were included in the study. Cases with clinical evidence of infection, pathological fractures, multiple injuries including neurovascular injuries were excluded from the study. The patients were randomly assigned into two groups; Group-I (n-32) patients who underwent early spica application while Group-II (n-32) patients underwent skin traction in followed by spica cast. Results: Mean age in group A was 5.06 years and 5.12 years in group B (range 6 months to 10 years). Ratio of males and female in Group A and Group B was 19:13 and 20:12 respectively. Average duration of hospital stay was 1.65 days and 11.65 days in group A and Group B respectively. Average total time of spica cast application was 45.13 days and 49.41 days in group A and group B patients respectively. Conclusion : There were no significant differences between early and delayed spica regarding the complications of treatment and functional outcome. But immediate spica decreased the hospitalization time and the cost of treatment significantly with increased availability of beds while having similar result as achieved by delayed spica application.