Immediate Versus Delayed Hip Spica For Pediatric Shaft Femur Fractures- A NonRandomised Clinical Trial
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 1
Abstract
Context: Multiple treatment options are available for pediatric femoral shaft fractures. For age of 1- 6 years, treatment is either by immediate hip spica or traction followed by delayed hip spica application. Aims: To compare clinical outcome of both treatment modalities with a minimum follow up of 2 years.Material and Methods:Aprospective non-randomised trial was carried out in the Department of Orthopaedics from May 2011 to May 2014. All closed femoral shaft fractures without neurovascular deficit in children aged 1- 6 years were included in the study. Group 1 was treated with immediate spica casting and group 2 with traction and delayed spica casting. Both groups were followed up for a minimum of 2 years and evaluated clinically and radiologically. Results: In our study immediate spica group (ISG) had a mean hospital stay of 2.5 days compared to 23.8 days in delayed spica group (DSG). Time to union was 10 weeks in immediate spica group compared to 9.2 weeks in delayed spica group. Only 3% patients in ISG had ROM restriction at 12 weeks compared to 17.2% in DSG. Malunion and Limb length discrepancy rates were similar. There were more pressure sores in DSG compared to ISG. There was no incidence of delayed union/ nonunion, or infection. Conclusion: Both immediate and delayed hip spica casting provide satisfactory results. Immediate spica casting avoided the longer hospital stay. Complications of prolonged traction, including pressure sores and joint stiffness are avoided as well.
Authors and Affiliations
P V Siddhartha, Vishal Bansal, Harish Rao, Biraj Ray, Hemant Khajja
Keywords
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