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Topic:

Femoral Shaft Fracture

Issue:

Thigh

Category:

Trauma

Title:

Waterproof Hip Spica Casts for Pediatric Femur Fractures

Author:

Churchill, Jessica L. MD; Kronk, Trinity A. BS; Adamczyk, Mark J. MD; Brown, Miraides F. PhD; Ritzman, Todd F. MD; Floccari, Lorena V. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e20-e24, DOI: 10.1097/BPO.0000000000002541

Level Of Evidence:

III

# of Patients:

50

Study Type:

Retrospective matched cohort study

Location:

Not specified

Summary:

This study evaluates the safety and efficacy of waterproof (WP) hip spica casts compared to traditional spica (TS) casts for pediatric femur fractures.

Methods:

Procedure: Retrospective study of pediatric patients ≤5 years with femur fractures treated with hip spica casts. Interventions: Matched comparison between WP and TS casts, with TS using Goretex liner and cotton padding, and WP using fully waterproof materials. Outcomes Measured: Operative time, length of stay, length of time in cast, patient charges, coronal/sagittal alignment, shortening, and skin/cast complications.

Exclusions:

Not specified

Results:

Patient Demographics: No differences in age, weight, or sex between cohorts. Clinical Outcomes: No differences in operative time, length of stay, or length of time in cast. Patient charges: Significantly lower in the WP group ($230 vs. $301, P<0.001). Complications: 9 TS patients had minor skin and/or cast complications requiring outpatient repair vs. only 1 WP patient (P<0.001). Fracture Healing: Similar coronal/sagittal alignment and shortening at cast-off in both groups.

Conclusions:

WP spica casting is safe and efficacious for treating pediatric femur fractures, with reduced skin and cast complications compared to traditional spica casting and lower charges for WP cast materials. There were no significant differences in fracture healing, alignment, or shortening. WP spica casting also allows for bathing.

Relevance:

Limitations:

Perspective:

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