Treatment of Femur Fractures in Preschool Children with Double Pin Technique: Immediate Incorporated Hip Spica...

Area of Science:

• Pediatric Orthopedics
• Traumatology
• Surgical Techniques

Background:

• Hip spica casting is a common treatment for pediatric femoral fractures.
• Femoral shortening is a significant complication that must be avoided.
• Existing techniques require evaluation for optimal outcomes in young children.

Purpose of the Study:

• To describe and evaluate a novel immediate hip spica casting technique with double K-wire pinning for preschool children with femoral fractures.
• To assess the efficacy of this combined technique in correcting angular deformities and leg length discrepancies.

Main Methods:

• Sixteen preschool children with femoral fractures were treated under general anesthesia using a double K-wire pinning technique followed by hip spica casting.
• K-wires were inserted in the supracondylar and proximal femoral regions to maintain reduction during casting.
• The technique involved specific application of the spica cast, excluding the contralateral knee.

Main Results:

• Post-casting angulation was 9.1° frontal and 8.9° sagittal; final angulation after cast removal was 8.5° frontal and 9° sagittal, with no significant difference.
• The mean leg length discrepancy at cast removal was 4.8 mm.
• No significant angular deformities or length discrepancies were observed post-treatment.

Conclusions:

• The described immediate hip spica casting with double K-wire pinning is an effective technique for managing femoral diaphyseal fractures in preschool children.
• This method successfully combines principles of external fixation and hip spica casting to correct deformities.
• The technique shows promise in achieving acceptable outcomes regarding alignment and limb length in this pediatric population.