HIP & FEMUREarly versus late hip spica casting for paediatric femoral shaft fracturesYounis, Manaf H.; Mahmoud, Karim; Kawas, Alaa; Ibrahim, TalalAuthor Information Section of Orthopedics, Department of Surgery, Hamad General Hospital, Doha, Qatar Correspondence to Talal Ibrahim, MD, MSc, FRCS(Orth), FRACS, Section of Orthopedics, Department of Surgery, Hamad General Hospital, PO Box 3050, Doha, Qatar Tel: +974 4439 2820; fax: +974 4439 2608; e-mail: email@example.com Journal of Pediatric Orthopaedics B: March 2019 - Volume 28 - Issue 2 - p 122-126 doi: 10.1097/BPB.0000000000000558 Buy Metrics Abstract The purpose of our study was to evaluate the effectiveness of treating paediatric femoral shaft fractures by early (<48 h) versus late (>48 h) hip spica casting. A retrospective review of 44 patients with 44 femoral shaft fractures treated by either early or late hip spica application with at least 9-month follow-up was undertaken. Both groups were treated on an inpatient basis. The late hip spica group had skin traction applied before the application of a hip spica. The outcome measures involved both clinical [Pediatric Outcomes Questionnaire (POQ) and Activities Scale for Kids (ASK)] and radiological outcomes. Complications were noted. A total of 44 patients with a mean age of 33 months (range: 7–66 months) were evaluated. Overall, 20 patients underwent early and 24 had late hip spica casting. At follow-up, the ASK was similar amongst the two groups (44.2 vs. 44.8, P=0.8). However, the POQ was better in the early hip spica casting group (24.7 vs. 28.9, P=0.01). Length of hospital stay and duration of immobilization in the hip spica were significantly shorter in the early group (P<0.001). There were no differences in leg lengths, lateral distal femoral angles and medial proximal tibia angles between the fractured and nonfractured limbs in both groups. Early hip spica casting is a safe procedure for paediatric femoral shaft fractures and was associated with less time in hospital and hip spica with a better POQ score. However, early hip spica casting was associated with more hip spica changes and required wedging. At follow-up, radiological parameters were similar in both groups. Level of Evidence: III. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.