HIP SPICA CASTS IN THE MANAGEMENT OF FEMORAL SHAFT FRACTURES IN YOUNG CHILDREN

Shaft fractures occur frequently in young children leading to hospital admission. Most of them are treated using closed non-operative methods. Rich blood supply of the shaft allows rapid healing and favorable outcome. Objective: To compare primary hip spica cast versus secondary hip spica cast in management of fracture shaft of femur in children less than 6 years of age in terms of frequency of limb length discrepancy. Study Design: Randomized control trial Settings: Orthopedic department of Allied and DHQ hospital FSD. Duration of Study: May, 2018 to Dec, 2018 Subjects & Methods: All children of age 6 months to 6 years with femoral shaft fracture were admitted and randomly divided into two groups. One was treated with primary hip spica cast done within 24 hours and other was treated with secondary hip spica cast after initial traction. After six weeks of follow-up limb length discrepancy was assessed. Results: Total 310 cases fulfilling the inclusion/exclusion criteria were enrolled. Mean and standard deviation for age was calculated as 36.43+16.117 months. Gender distribution showed 81.6% (n=253) male and 18.4% (n=57) females. Limb shortening was seen in 9% (n=28) patients including 5.2% (n=8) from the primary hip spica group and 12.9% (n=20) from the secondary hip spica group. Conclusion: The outcome of primary hip spica cast in femoral shaft fractures in children is better with low frequency of limb length discrepancy as compared to secondary hip spica cast, and it can be used in population as an effective method. Key Word: Shaft fractures, Pediatric fractures, Primary Spica Cast, Secondary Hip Spica, Limb Length discrepancy, limb shortening