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Webril-only Soft Spica Cast for Pediatric Femoral Fractures: A Preliminary Study
Achraf Jardaly1, Matthew Hess2, Michael Conklin2
1Lebanese American University, Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon; University of Alabama at Birmingham, Department of Orthopedic Surgery, Alabama.
Insights
A soft spica cast, a low-cost option, effectively treats femur fractures in infants. This method is as safe and effective as traditional treatments, with fewer complications.
Area of Science:
- Pediatric Orthopaedics
- Biomechanical Engineering
Background:
- Femur fractures are common in infants.
- Traditional treatments include Pavlik harness and hard spica casts.
- The efficacy and safety of soft spica casts are not well-established.
Purpose of the Study:
- To evaluate the outcomes and complications of soft spica casts for infant femur fractures.
- To compare soft spica casts with other treatment modalities.
Main Methods:
- Retrospective study of 43 infants younger than 6 months with diaphyseal femur fractures.
- Comparison of treatment groups: Pavlik harness (26), hard spica cast (8), and soft spica cast (9).
- Average treatment duration was 3 weeks.
Main Results:
- All fractures healed with similar final angulation and shortening across all groups.
- Hard spica casts were associated with the highest complication rates.
- Soft spica casts had the lowest material cost ($2) compared to Pavlik harness ($87-$107) and hard spica casts ($150).
Conclusions:
- Soft spica casts are an effective and safe treatment for infant femur shaft fractures.
- Advantages include ease of application, management, and significantly lower cost.
- This method offers a viable alternative to traditional treatments.
Abstract:
We report using a spica cast created with cotton padding and Ace wrap without a rigid component for femur fracture in infants. Outcomes and complications of this soft spica cast were retrospectively compared with other treatments. There were 43 children younger than 6 months (43 diaphyseal fractures) included in the study. Treatment was a Pavlik harness (26 patients), a hard spica cast (8), or a soft spica cast (9) for an average of 3 weeks. All fractures demonstrated healing with similar final angulation and shortening. Hard spica casts caused the most complications. As for material costs, the soft spica is the least costly method ($2 per cast versus $87-$107 for Pavlik harness and $150 for hard spica). In conclusion, soft spica casts are as effective as other treatment options for femoral shaft fractures in young children. These casts are advantageous since they are easier to apply, easier to manage, and have a lower cost. (Journal of Surgical Orthopaedic Advances 30(1):040-043, 2021).
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