Abstract
This prospective descriptive study aims to assess the importance of the immediate hip spica in a fracture of the femoral shaft in children at the Orthopedic Department of Liaqat University of Medica and Health science Jamshoro, Pakistan, for a one-year duration from June 2019 to June 2020. All children 1 to 5 years of age with femoral fractures who were admitted to the Orthopedic department within seven days of injury were included in the study. A total of 35 children, 24 (68.6%) boys and 11 (31.42%) girls, with a mean age of 3.8 years, were treated with an immediate hip spica cast. Their ages ranged from 1 to 5 years. The time of immobilization of the Spica cast ranged from 4 to 6 weeks (mean 5.4 weeks). In the second week, seven (22.85%) children had spica wetting, and breakage and reinforcement of spica was done, and 5 (14.28%) children had a spica wedging, and casting was applied to fix the angulation. No extension or hypertrophy was observed in the fractured limb. We concluded that immediate hip spica casting is a safe, inexpensive and definitive treatment of femoral shaft fractures in children aged 1-5 years.
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References
Alam, F., Rehman, Z. U., Shaukat, M. K. 2019. Comparison of limb length discrepancy in children with femur shaft fracture treated with primary hip spica versus secondary hip spica. Journal of University Medical and Dental College, 10(2):7–15.
Amin, U., Asim, M., Nawaz, I., Zubair, A. 2020. Paediatric Femur Fractures and Long Leg Splinting. Asian Journal of Multidisciplinary Studies, 8(1).
Asimuddin, M., Lohith, N., Mahajabeen, A. 2019. A clinical study of treatment of paediatric femoral shaft fractures with elastic intramedullary nail. International Journal of Orthopaedics Sciences, 5(4):153–155.
Brnjoš, K., Lyons, D. K., Hyman, M. J., Patel, N. M. 2020. Spica Casting Results in More Unplanned Reoperations than Elastic Intramedullary Nailing: A National Analysis of Femur Fractures in the Preschool Population. JAAOS: Global Research and Reviews, 4(10):e20.00169.
Chetia, N. P., Medhi, H., Das, M., Bidyananda, A. 2020. The outcome of adult proximal humerus locking plate in the treatment of paediatric subtrochanteric fractures. International Journal of Research in Orthopaedics, 6(1):63.
Compton, E., Andras, L. M., Murgai, R. R., Skaggs, D. L., Illingworth, K. D. 2020. Isolated femoral shaft fractures in children rarely require a blood transfusion. Injury, 51(3):642–646.
Curran, P. F., Albright, P., Ibrahim, J. M., Ali, S. H., Shearer, D. W., Sabatini, C. S. 2020. Practice Patterns for Management of Pediatric Femur Fractures in Low- and Middle-Income Countries. Journal of Pediatric Orthopaedics, 40(5):251–258.
Das, R. K., Hoque, M. J., Zamman, M. E., Islam, F. 2020. Comparative study of day 01 spica cast versus skin traction followed by spica cast for treatment of closed femoral shaft fracture in children. Z H Sikder Women’s Medical College Journal, 2(Number 1):16–19.
Edwin, A., Sha, I. I., Roshna, S. R., Shah, N. 2020. Clinical and functional outcome of elastic stable intramedullary nailing in pediatric femoral fractures in the age group of 5-16 years. International Journal of Research in Orthopaedics, 6(5):1037.
Gao, H., Wang, Z., Su, Y. 2020. Surveillance ultrasonography for conservative treatment of femoral shaft fractures in young children. Journal of Orthopaedic Surgery and Research, 15(1):604.
Gordon, J. E., Anderson, J. T., Schoenecker, P. L., Dobbs, M. B., Luhmann, S. J., Hoernschemeyer, D. G. 2020. Treatment of femoral fractures in children aged two to six: a multicentre prospective case series. The bone and Joint Journal, 102(8):1056–1061.
Kim, V., Mashru, R., Graf, K. 2020. Management of Pediatric Femur Fracture with use of 90-90 Traction and Delayed Spica Casting: Case Report. Cooper Medical School of Rowan University, pages 1–3.
Liau, G. Z., Lin, H. Y., Wang, Y., Nistala, K. R., Cheong, C. K., Hui, J. H. 2020. Pediatric Femoral Shaft Fracture: An Age-Based Treatment Algorithm. Indian Journal of Orthopaedics, 55(1):55–67.
Luo, Y., Wang, L., Zhao, L. H., Wang, Y. C., Chen, M. J., Wang, S., Ma, Q. C. 2019. Elastic Stable Titanium Flexible Intramedullary Nails Versus Plates in Treating Low-Grade Comminuted Femur Shaft Fractures in Children. Orthopaedic Surgery, 11(4):664–70.
Makarewich, C. A., Talwar, D., Baldwin, K. D., Swarup, I. 2020. Flexible intramedullary nailing of femoral shaft fractures in children weighing≥ 40 kg: a systematic review and meta-analysis. Journal of Pediatric Orthopaedics, 40(10):562–568.
Mcclure, P., Riccio, A. I. 2020. Comminuted Femoral Fracture Treated with Locked Enders Nails. Pediatric Orthopedic Trauma Case Atlas, pages 589–93.
Mehmood, M. S., Shah, S., Razzaq, S. 2019. Frequency of limb shortening in femoral shaft fractures treated by hip spica casting in children in Tertiary Care Hospital. The Professional Medical Journal, 26(11):1873–1877.
Misaghi, A., Mahmoud, M. A. H., Arkader, A., Baldwin, K. D. 2020. Fracture characteristics predict suboptimal alignment in preschool femoral shaft fractures treated with spica casting: a retrospective chart review. Current Orthopaedic Practice, 31(4):379–384.
Mishra, V. K., Kumar, A., Kumar, G. S., Sarang, S. 2020. Functional outcome of fracture shaft of femur in pediatric age group treated with titanium elastic nailing system. International Journal of Medical and Biomedical Studies, 4(1).
Prajapati, D. C., Maru, D. N., Makwana, D. V. 2019. Retrospective study of operative (Rush pin) versus conservative (Hip spica) management in treatment of diaphyseal femoral fractures in children. National Journal of Clinical Orthopaedics, 3(2):30–34.
Roaten, J. D., Kelly, D. M., Yellin, J. L., Flynn, J. M., Cyr, M., Garg, S., Broom, A., Andras, L. M., Sawyer, I. R. 2009. Pediatric femoral shaft fractures: a multicenter review of the AAOS clinical practice guidelines before and after. Journal of Pediatric Orthopaedics, 39(8):394–403.
Rosin, R. C., Rasool, M. N., Sibanda, W., Rollinson, P. D. 2019. Antegrade flexible intramedullary nailing through the greater trochanter in paediatric femur shaft fractures. SA Orthopaedic Journal, 18(4):1681–150.
Saeed, U. B. 2019. Functional Outcome in Primary Hip Spica in Children Under 5 Years. Annals of Punjab Medical College (APMC), 13(1):7–9.
Trailescu, M. D., Socea, B., Gheorghiu, N., Gheorghiu, D., Dimitriu, M., Bacalbasa, N., Pacu, I., Cirstoveanu, C., Pavel, A. I., Pop, M. A., Furau, C. G. 2020. Osteosynthesis in Children with Titanium Elastic Nails in Ipsilateral Lower Limb Fractures. Revista de Chimie, 71(5):409–413.
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