Early spica cast management of femoral shaft fractures in young children. A technique utilizing bilateral fixed skin traction.

A review was made of 20 of 27 consecutively treated patients under 9 years of age with femoral shaft fractures treated by early application of bilateral fixed skin traction spica cast. The patients were re-evaluated two or more years after treatment, clinically and radiologically. All patients were asymptomatic and unaware of any disability. Orthodiagrams revealed no disparity of leg length greater than 7 mm. Residual anterior bow of 12 degrees was present in two patients and in 5 rotational malalignment of 10 to 20 degrees was present. As compared with results treated in traction, this method provides improved length control, comparable control of angular and rotational alignment and considerably shortened hospital stay. The technique should only be used by experienced, careful orthopedists in individually selected cases.