Pidgeon Tyler S, Schiller Jonathan
From the Division of Pediatric Orthopedics and Scoliosis, The Warren Alpert Medical School of Brown University; and the Department of Orthopedic Surgery, Rhode Island Hospital, Providence, RI.
Pediatr Emerg Care. 2017 May;33(5):329-333. doi: 10.1097/PEC.0000000000000508.
The aim of the study was to describe the long leg cast with a pelvic band (LLCPB), a novel alternative to spica casting for treating femur fractures in patients aged 6 months to 6 years which requires no casting above the waist, allows for hip flexion adjustments after it is applied, and does not require an operating room for placement.
Seven children aged 7.9 months to 3.7 years with femur fractures treated with the LLCPB at a single institution were retrospectively studied. All children were casted in the emergency department under conscious sedation. Radiographic and subjective outcomes were recorded.
All 7 children achieved acceptable reduction of their fractures without the need for re-reduction or cast wedging. Five of the 7 children were discharged from the emergency department; 1 child required 1 night of hospitalization and another child required 2 nights of hospitalization. There were no complications. The cost of placing an LLCPB at our institution was $430.46. The cost of placing a spica cast in the operating room was $5427.54 to $6465.00.
The long leg cast with a pelvic band seems to be an acceptable treatment for children aged 8 months to 4 years with spiral femur fractures. This technique has significant advantages over traditional and modified spica casts including allowing for uninhibited toileting, weight bearing on the unaffected leg, adjustment of hip flexion at any point after placement, and easier access to the perineum, abdomen, and chest for hygienic and medical purposes. Furthermore, treatment with an LLCPB presents significant potential for cost savings.
本研究的目的是描述带骨盆带的长腿石膏（LLCPB），这是一种治疗6个月至6岁儿童股骨骨折的新型替代髋人字石膏的方法，该方法无需腰部以上打石膏，应用后可进行髋关节屈曲调整，且放置时无需手术室。
回顾性研究了在单一机构接受LLCPB治疗的7例年龄在7.9个月至3.7岁的股骨骨折患儿。所有患儿均在急诊室清醒镇静下打石膏。记录影像学和主观结果。
所有7例患儿骨折均获得可接受的复位，无需再次复位或石膏楔形矫正。其中5例患儿从急诊室出院；1例患儿需要住院1晚，另1例患儿需要住院2晚。无并发症发生。在我们机构放置一个LLCPB的成本为430.46美元。在手术室放置髋人字石膏的成本为5427.54美元至6,65.00美元。
带骨盆带的长腿石膏似乎是治疗8个月至4岁螺旋形股骨骨折患儿的一种可接受的治疗方法。该技术与传统和改良的髋人字石膏相比具有显著优势，包括允许无限制如厕、健侧腿负重、放置后任何时候均可调整髋关节屈曲，以及为卫生和医疗目的更方便地接触会阴、腹部和胸部。此外，使用LLCPB治疗具有显著的成本节约潜力。
