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