Traction spica cast for femoral-shaft fractures in children

Abstract

We treated 20 children for an isolated femoral shaft fracture using distal tibial traction incorporated into a spica cast with the knee in full extension. Patients were discharged from the hospital at a mean of 5.1 days following injury. All fractures healed, and there were four minor complications. At a mean follow-up of 35 (13-72) months, all patients were asymptomatic with normal function. All but one fracture healed in acceptable alignment, and there was no clinically significant leg-length discrepancy. The method is relatively simple to employ and may be advantageous in a setting of limited resources.Résumé Nous avons traité 20 enfants pour une fracture de la diaphyse fémorale isolée avec une traction tibiale distale incorporée dans le spica avec le genou en extension complète. Les malades ont quitté l'hôpital en moyenne 5.1 jours après le traumatisme. Toutes les fractures ont consolidé, et il y avait 4 complications mineures. À une moyenne de suivi de 35 (13-72) mois tous les malades étaient assymptomatiques avec une fonction normale. Toutes les fractures sauf une ont guéri avec un alignement acceptable, et il n'y avait aucune différence de longueur cliniquement. La méthode est relativement simple à emploi, et peut être avantageuse dans un cadre de ressources limitées.

Systematic review of spica casting for the treatment of paediatric diaphyseal femur fractures

“…In all, 51 articles specifically mentioned the use or non-use traction in their description of spica application and the course of patient care. Of the articles detailing the use of traction, seven specifically had no traction, 12 , 15 , 23 , 25 , 27 , 61 , 103 12 used isolated skin traction, 20 – 22 , 35 , 36 , 46 , 48 , 53 , 59 , 62 , 68 , 76 and 19 used skeletal traction on some, if not all, of their patients via a Kirschner wire applied to either the distal femur, 10 , 18 , 19 , 24 , 33 , 38 , 41 , 57 , 64 , 67 , 72 , 80 , 94 proximal tibia 13 , 26 , 45 , 97 or unspecified pin location. 52 , 82 Eight retrospective reviews had patients within their cohorts who had received either skin traction or skeletal traction, 17 , 34 , 40 , 56 , 64 , 82 , 86 , 102 but no direct comparison was made between these two treatment options.…”