Clinical Findings in 2 Techniques of Spica Casting in Treatment of Femoral Shaft Fractures in Children

Femoral shaft fracture is the most prevalent major orthopedic injury in children. Usually, we use two methods for spica casting for femoral shaft fractures. This survey aimed two compare them.
This single-blind randomized clinical trial study was performed on the 35 2- to 6-years-old patients with isolated and non-complicate femoral shaft fracture referred to Shahid Bahonar hospital, Kerman, Iran. All the patients were followed for 6 months. 17 patients were treated with type 1 method (90/90 casting) and 18 ones underwent type 2 method (45/45 casting). Patient was examined in regard of limb length, angular deformity, muscle power, neurovascular lesion, compartment syndrome, and dermal injury. After opening the cast, a researcher-made questionnaire about the child's activities was completed by parents.
Findings: In all the patients in both groups, after maximum of 8 weeks, union was completed. The average difficulty in moving around independently was 5.77 ± 2.41 and 8.05 ± 1.43 in 45/45 and 90/90 groups, respectively, with a significant difference (P = 0.002). The average difficulty rate of leaving family residence or was 5.77 ± 2.94 and 8.00 ± 1.76 in 45/45 and 90/90 groups, respectively, which was statistically different (P = 0.011).
Based on the results of the present study, it seems that the child is more comfortable with 45/45 spica cast.