Spica Casting in Pediatric Femur Fractures: Study of Single Leg Versus Double Leg Spica Casts

Spica Casting in Pediatric Femur Fractures: A Prospective Randomized Controlled Study of Single Leg vs Double Leg Spica Casts

Prospective randomized controlled trial comparing use of single leg spica with double leg spica casts in the treatment of pediatric femur fractures in children ages 2 through 6 years old.

Introduction

• double-leg spica casting is the treatment of choice at many centers for the treatment of diaphyseal femur fractures in children 2 to 6 years old.
• Investigators hypothesize that these patients can be effectively treated with single-leg spica casting and that such treatment will result in easier care and better patient function during treatment.

Methods

• Prospective randomized controlled study of patients between 2 and 6 years old with diaphyseal femur fractures
• patients randomly assigned to either immediate single or double-leg spica casting groups after consent was obtained
• Radiographs serially evaluated for maintenance of reduction with respect to length, varus/valgus angulation and procurvatum/recurvatum angulation
• After casts removal, the Activity Scale for Kids (Performance Version) questionnaire and a custom written survey were given to parents evaluating ease of care and function of children during treatment.

Inclusion Criteria:

• diaphyseal femur fracture
• age between 2 and 6 years old

Exclusion Criteria:

• underlying bone disorder
• neuromuscular disease