Treatment Of School-Age Children With Femoral Shaft Fracture: Spica Casting Versus Titanium Elastic Nail Fixation

Femoral shaft fractures are mostly seen in children and all cases of this condition require hospital admission. In school-age children (5 to 12 years), femoral fractures may be treated with elastic nails or spica cast. The current study aims to compare the outcomes of elastic nail to the immediate spica cast method for school-age children with femoral fracture. We evaluated the patients who had undergone immediate hip spica cast (IHSC as Group 1; n=31) or flexible intramedullary titanium nail (FITN as Group 2; n=31) for femoral fracture. Age, sex, cause of fracture, localization of the fracture, cost of treatment, times of hospitalization, radiologic and clinical assessment of femoral union, condition of the wound and soft tissue, times of union and walking were recorded. The mean followup was 58 (26-62) months. All fractures were healed. The time for weight-bearing and walking were shorter (39/52) in Group 2 than it was in Group 1 (52/63). In terms of cost, IHSC (114.99$) was cheaper than FITN (380.82$). Although IHSC is still a a widely accepted method of treatment, with the use of modern surgical techniques and implants, satisfactory outcomes of fracture healing can make FITN a better surgical option among all other treatments.