Fri., 10/15/10 Knee, Tibia & Pediatrics, Paper #62, 4:38 pm OTA-2010
Spica Casting in Pediatric Femur Fractures: A Prospective Randomized Controlled Study of 1-Leg versus 1.5-Leg Spica Casts
Dirk Leu, MD; Erkula Gurkan, MD; M. Catherine Sargent, MD; Michael C. Ain, MD;
Arabella I. Leet, MD; John E. Tis, MD; Gregory M. Osgood, MD; Paul D. Sponseller, MD;
Johns Hopkins Hospital, Baltimore, Maryland, USA
Background: 1.5-leg spica casting is the treatment of choice at many centers for the treatment of diaphyseal femur fractures in children 2 to 6 years of age. We hypothesize that these patients can be effectively treated with 1-leg spica casting and that such treatment will result in easier care and better patient function during treatment.
Methods: In a prospective randomized controlled study of 52 patients between 2 and 6 years of age with diaphyseal femur fractures, patients were randomly assigned to either immediate 1- or 1.5-leg spica casting groups after consent was obtained. Radiographs were serially evaluated for maintenance of reduction with respect to length, varus/valgus angulation, and procurvatum/recurvatum angulation. After casts were removed, the Activity Scale for Kids (Performance Version) questionnaire and a custom written survey were given to the parents evaluating ease of care and function of children during treatment.
Results: All children healed in satisfactory alignment. Children treated with 1-leg spica casts were more likely to fit into car seats (P < 0.05) and fit more comfortably into chairs(P < 0.05). Caretakers of patients treated with 1-leg casts took less time off of work (P < 0.05). There was also a trend toward more walking (P = 0.076) in the 1-leg group. There were no major complications in either group.
Conclusion/Discussion: Treatment of pediatric femur fractures with 1-leg spica casts is effective and safe and results in more facile care and better function of children with femur fractures during treatment.
Alphabetical Disclosure Listing (292K PDF)
• The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an “off label” use). ◆FDA information not available at time of printing. Δ OTA Grant.