Femoral Shaft Fracture in Children Traction and Spica Casting  Versus Immediate Spica Casting. (Clinical Comparative Study)

A.A Alzubady, Ihssan; H. Almuhana, Hussain

	Femoral Shaft Fracture in Children Traction and Spica Casting Versus Immediate Spica Casting. (Clinical Comparative Study)
Medical Journal of Babylon
Article 1, Volume 7, Issue 1, 2010, Pages 43-51
Authors
Ihssan A.A Alzubady; Hussain H. Almuhana
Abstract
One hundred child with isolated non complicated femoral shaft fracture included in this clinical comparative study ,between 2005-2007 in Aldiwania teaching hospital. 50 child treated by immediate application of hip spica cast under general anesthesia and discharge of the child at the same day. Other 50 child treated by preliminary skin traction in the hospital for a period 2-3 weeks then after application of hip spica under general anesthesia. After removal of the cast from all the children (6-8 weeks),shorting was seen in all children treated by immediate cast (43 case less than 2 cm ,7 cases more than 2 cm which regarded as a failure) while in other group shorting less than 2 cm was seen in 46 case , and more than 2 cm in 4 cases only.(p value more than 0.05, non significant). After 2 years ,at the last follow up, limb length discrepancy was found only in 5 cases in children treated by immediate casting and in 4 cases treated by delay casting .which is non significant in both group. there’s no significant angulations in both groups on short or late follow up. so we concluded that immediate hip spica cast application as definitive treatment for femoral shaft fracture in children between 2-10 years old represent an a good alternative method for the traditional method of preliminary traction in hospital and then hip spica. In addition its economic , safe, with short hospital stay and rapid return of the child to family.

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