PMID: 9170364May 1, 1997Paper

Shortening in femoral shaft fractures in children treated with spica cast

Clinical Orthopaedics and Related Research
J D ThompsonP P Griffin

Abstract

Early spica cast treatment is one method used for children's femoral shaft fractures; it is increasingly advocated as treatment that allows early hospital discharge. The outcome of early spica cast treatment in 100 children, ages 2 to 10 years, with uncomplicated and isolated closed femoral shaft fractures treated at Johns Hopkins Hospital between October 1987 and March 1994 were analyzed. The objective was to identify those children who can be treated safely and dependably with early spica casting without excessive shortening of the fracture fragments. Eighty-one (81%) children had an acceptable outcome and 19 (19%) had an unacceptable outcome by the definition of more than 25 mm of fracture fragment overlap after clinical healing. A new clinical test, the telescope test, was statistically significant for correlation with spica cast outcome. Age, gender, fracture, location, mechanism of injury, fracture type, and resting radiograph of fracture fragment overlap were not statistically significant. The telescope test had a sensitivity of 80% and a specificity of 85% for predicting outcome. The relative risk for failure of spica cast treatment with a positive telescope test was 20.4 (95% confidence limits = 2.7-225.1). Children 2 ...Continue Reading

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Aug 1, 1986·The Journal of Bone and Joint Surgery. British Volume·D A Clement, C L Colton
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Citations

Jul 25, 2000·Clinical Orthopaedics and Related Research·A F InfanteJ T Lehner
Jun 23, 2006·Journal of Pediatric Orthopedics·Howard R EppsDaniel P O'connor
May 1, 2018·Journal of Children's Orthopaedics·R T TishermanS A Mendelson
Dec 15, 2010·Journal of Pediatric Orthopedics·Rachel DiFazioTravis Matheney
Jun 13, 2017·The Open Orthopaedics Journal·Rakesh JohnAnkit Khurana
Mar 10, 2018·Journal of Pediatric Orthopedics·Ena NielsenLindsay M Andras
Sep 21, 2018·JBJS Essential Surgical Techniques·M Catherine Sargent
Sep 5, 1998·Clinical Orthopaedics and Related Research·W B Greene
Mar 30, 2005·Lancet·James G WrightPeter Coyte

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