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Similar Outcomes for Walking, Traditional Hip Spica Casts

Walking cast reduces family care burden after low-energy femoral shaft fracture in young children

WEDNESDAY, Dec. 14 (HealthDay News) -- A single-leg walking hip spica cast is as effective as a traditional hip spica cast for the treatment of low-energy femoral shaft fractures in young children, and reduces the care burden for the family, according to a study published in the Dec. 7 issue of The Journal of Bone & Joint Surgery.

John M. Flynn, M.D., from The Children's Hospital of Philadelphia, and colleagues examined whether a walking hip spica cast was superior to a traditional hip spica cast after a low-energy femoral shaft fracture in 45 children, aged 1 to 6 years. Data were gathered from caregivers via the validated Impact on Family Scale and a questionnaire at the time of cast removal, and from prospectively recorded complications and subsequent interventions.

The investigators found that, of the 26 patients treated with a traditional cast, two returned to the operating room for treatment of spontaneous loss of fracture reduction, compared with none of the 19 patients in the walking cast group. Wedge adjustment of the cast in the clinic was needed to treat fracture malalignment in one patient in the traditional cast cohort and five patients in the walking cast cohort. The groups showed no significant difference in the malunion rates. Families experienced a significantly higher care burden with the traditional hip spica cast. Eleven patients in the traditional cast cohort required insurance-funded ambulance transportation, compared with none of the patients in the walking cast cohort.

"The walking hip spica cast and the traditional hip spica cast resulted in similar orthopedic outcomes, and the walking hip spica cast resulted in a lower care burden for the family," the authors write.

One or more of the authors disclosed financial ties to an entity in the biomedical arena.

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