Dynamic skeletal traction spica casts for paediatric femoral fractures in a resource-limited setting

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Trauma care

Background:

• Femoral fractures are common in children.
• Treatment options include elastic intramedullary nailing (EIN) and dynamic skeletal traction spica casting (DSTSC).
• Resource-limited settings present unique challenges for orthopedic interventions.

Purpose of the Study:

• To compare the efficacy of EIN versus DSTSC for pediatric femoral fractures.
• To evaluate postoperative radiographic angulation, hospital stay duration, and cost.
• To assess treatment feasibility in resource-limited healthcare environments.

Main Methods:

• Prospective study of 51 children (5-12 years) with femoral fractures.
• Patients were treated with either EIN (n=26) or DSTSC (n=25).
• Outcomes measured included radiographic angulation, hospital stay, and cost.

Main Results:

• Both EIN and DSTSC achieved acceptable radiographic angulations at 12 weeks.
• DSTSC group had significantly shorter hospital stays (6.0 days) than EIN group (17 days).
• EIN treatment was approximately 400% more expensive and had longer pre-operative delays due to supply issues.

Conclusions:

• Dynamic skeletal traction spica casting (DSTSC) is an effective and more economical alternative to elastic intramedullary nailing (EIN) for pediatric femoral fractures.
• DSTSC leads to reduced hospital stays and lower costs in resource-limited settings.
• Comparable radiographic outcomes support DSTSC as a viable treatment option.