Complication of Early Application of One and a Half Hip Spica for Femoral Shaft Fractures in Children Below Six Years in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Overview

Journal JNMA J Nepal Med Assoc

Specialty General Medicine

Date 2022 Feb 24

PMID 35199694

Authors

Poojan Kumar Rokaya

Mangal Rawal

Tufan Singh Kathayat

Abhishek Kumar Thakur

Monika Lama

Ramu Maharjan

Affiliations

Soon will be listed here.

Abstract

Introduction: Hip spica with or without prior traction has become a standard treatment for closed isolated femoral shaft fracture in children below six years. The time of hip spica application is not uniform in the existing literature. The aim of this study is to find out the prevalence of complication of early application of one and a half hip spica for femoral shaft fractures in children below six years in a tertiary care hospital. Methods: A descriptive cross-sectional study was done among 42 children who were managed with early hip spica application (within 72 hours) for femoral shaft fracture from January 2015 to December 2020 after receiving ethical clearance from Institutional Review Committee. Convenient sampling technique was done. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Complication was seen in nine (21.4%) (95% Confidence Interval= 9.02-33.84) patients. Skin breakdown from local pressure had the highest prevalence in our study which was documented in three (7.14%) patients who resolved with conservative treatment. Conclusions: The prevalence of complication of early application of one and a half hip spica for femoral shaft fractures in children below six years was similar to other studies done in similar setting.

References

Tisherman R, Hoellwarth J, Mendelson S . Systematic review of spica casting for the treatment of paediatric diaphyseal femur fractures. J Child Orthop. 2018; 12(2):136-144. PMC: 5902747. DOI: 10.1302/1863-2548.12.170201. View

Nork S, Bellig G, Woll J, Hoffinger S . Overgrowth and outcome after femoral shaft fracture in children younger than 2 years. Clin Orthop Relat Res. 1999; (357):186-91. DOI: 10.1097/00003086-199812000-00024. View

Ferguson J, Nicol R . Early spica treatment of pediatric femoral shaft fractures. J Pediatr Orthop. 2000; 20(2):189-92. View

Anglen J, Choi L . Treatment options in pediatric femoral shaft fractures. J Orthop Trauma. 2005; 19(10):724-33. DOI: 10.1097/01.bot.0000192294.47047.99. View

Berne D, Mary P, Damsin J, Filipe G . [Femoral shaft fracture in children: treatment with early spica cast]. Rev Chir Orthop Reparatrice Appar Mot. 2003; 89(7):599-604. View

Younis M, Mahmoud K, Kawas A, Ibrahim T . Early versus late hip spica casting for paediatric femoral shaft fractures. J Pediatr Orthop B. 2018; 28(2):122-126. DOI: 10.1097/BPB.0000000000000558. View

Mansour 3rd A, Wilmoth J, Mansour A, Lovejoy S, Mencio G, Martus J . Immediate spica casting of pediatric femoral fractures in the operating room versus the emergency department: comparison of reduction, complications, and hospital charges. J Pediatr Orthop. 2010; 30(8):813-7. DOI: 10.1097/BPO.0b013e3181fcb613. View

DiFazio R, Vessey J, Zurakowski D, Hresko M, Matheney T . Incidence of skin complications and associated charges in children treated with hip spica casts for femur fractures. J Pediatr Orthop. 2010; 31(1):17-22. DOI: 10.1097/BPO.0b013e3182032075. View

Casas J, Gonzalez-Moran G, Albinana J . Femoral fractures in children from 4 years to 10 years: conservative treatment. J Pediatr Orthop B. 2001; 10(1):56-62. View

10.

Jamaludin M . Femoral shaft fracture in children treated by early hip spica cast: early result of a prospective study. Med J Malaysia. 1995; 50(1):72-5. View

11.

Rasool M, Govender S, Naidoo K . Treatment of femoral shaft fractures in children by early spica casting. S Afr Med J. 1989; 76(3):96-9. View

12.

Splain S, Denno J . Immediate double hip spica immobilization as the treatment for femoral shaft fractures in children. J Trauma. 1985; 25(10):994-6. DOI: 10.1097/00005373-198510000-00012. View

13.

Illgen 2nd R, Rodgers W, Hresko M, Waters P, Zurakowski D, Kasser J . Femur fractures in children: treatment with early sitting spica casting. J Pediatr Orthop. 1998; 18(4):481-7. View

14.

Shemshaki H, Mousavi H, Salehi G, Eshaghi M . Titanium elastic nailing versus hip spica cast in treatment of femoral-shaft fractures in children. J Orthop Traumatol. 2011; 12(1):45-8. PMC: 3052430. DOI: 10.1007/s10195-011-0128-0. View

15.

Jauquier N, Doerfler M, Haecker F, Hasler C, Zambelli P, Lutz N . Immediate hip spica is as effective as, but more efficient than, flexible intramedullary nailing for femoral shaft fractures in pre-school children. J Child Orthop. 2011; 4(5):461-5. PMC: 2946524. DOI: 10.1007/s11832-010-0279-1. View

16.

Infante Jr A, Albert M, Jennings W, Lehner J . Immediate hip spica casting for femur fractures in pediatric patients. A review of 175 patients. Clin Orthop Relat Res. 2000; (376):106-12. DOI: 10.1097/00003086-200007000-00015. View

17.

dOllonne T, Rubio A, Leroux J, Lusakisimo S, Hayek T, Griffet J . Early reduction versus skin traction in the orthopaedic treatment of femoral shaft fractures in children under 6 years old. J Child Orthop. 2009; 3(3):209-15. PMC: 2686814. DOI: 10.1007/s11832-009-0174-9. View

18.

Wright J . The treatment of femoral shaft fractures in children: a systematic overview and critical appraisal of the literature. Can J Surg. 2000; 43(3):180-9. PMC: 3695159. View

19.

Frech-Dorfler M, Hasler C, Hacker F . Immediate hip spica for unstable femoral shaft fractures in preschool children: still an efficient and effective option. Eur J Pediatr Surg. 2009; 20(1):18-23. DOI: 10.1055/s-0029-1241177. View