ArticleJournal of children's orthopaedics2018
Systematic review of spica casting for the treatment of paediatric diaphyseal femur fractures.
Article in Journal of children's orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Treatment of closed femoral shaft fractures in children aged 2-10 years: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- Radiological effectiveness and cost analysis of the spica casting method without anesthesia in emergency room conditions for femoral shaft fractures in children under five years old.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- A retrospective cohort study comparing outcomes of spica casting in pediatric femoral shaft fractures by orthopedic surgeons fellowship trained in pediatrics vs. those not fellowship trained in pediatrics.Annals of medicine and surgery (2012) · 2025Article
- Hip Spica Cast Application.Journal of the Pediatric Orthopaedic Society of North America · 2025Review
- Dynamic Femur Fracture Brace vs Hip Spica Cast for Pediatric Femoral Shaft Fractures: A Retrospective Comparative Cohort Study.Journal of the Pediatric Orthopaedic Society of North America · 2025Article
- [Techniques of lower limb immobilization in children and adolescents].Operative Orthopadie und Traumatologie · 2025Article
- Titanium Elastic Nailing Versus Hip Spica Cast in the Treatment of Femoral Shaft Fractures in Children.Cureus · 2025Article
- Article
- Single-leg versus double-leg hip spica casts in the management of paediatric femoral shaft fractures? A systematic review and meta-analysis.Journal of clinical orthopaedics and trauma · 2024Review
- Trends in the Management of Femur Fractures in Young Children.Journal of the Pediatric Orthopaedic Society of North America · 2023Article
- Spica Casting of Pediatric Femur Fractures: The Pain Management Experience at One Institution.Cureus · 2022Article
- Epidemiology and associated injuries in paediatric diaphyseal femur fractures treated at a limited resource zonal referral hospital in northern Tanzania.BMC musculoskeletal disorders · 2022Article
- Femur fracture in a paediatric patient with hereditary hyaline fibromatosis syndrome.BMJ case reports · 2022Article
- Complication of Early Application of One and a Half Hip Spica for Femoral Shaft Fractures in Children below Six Years in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2021Article
- Pediatric Femoral Shaft Fracture: An Age-Based Treatment Algorithm.Indian journal of orthopaedics · 2021Review
- Length unstable femoral fractures: A misnomer?World journal of orthopedics · 2020Article
- Epidemiology of Femur Fractures in Children: A Descriptive Cross Sectional Study Based on a Rural Population of Nepal.JNMA; journal of the Nepal Medical Association · 2020Article
- Incidence of secondary interventions after early spica casting for diaphyseal femur fractures in young children.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePaediatric femur fractures are commonly encountered and often successfully managed with spica casting. Despite spica casting's long history there is little formal guidance for optimal outcomes and no consolidation of existing literature. The purpose of this study is to review the available literature regarding the use of spica casting for the management of paediatric diaphyseal femur fractures.
methodsThe PubMed database was queried for all research articles including the phrase "spica". A total of 788 abstracts were reviewed for relevance to the current study. Data was extracted from all available research studies which specified tolerance for fracture angulation or shortening in the cast. Additionally, all articles describing alternative materials, methods for spica application, and complications of spica casting were reviewed.
resultsIn all, 106 articles were found relevant to the management of diaphyseal femur fractures in the paediatric population. The aggregated, accepted fracture shortening decreased from 16 mm to 18 mm before age ten years to 12 mm to 14 mm after puberty. Aggregated, accepted angulation decreased from 14° to 16° varus/valgus and 18° to 22° pro/recurvatum before age two years, to 6° to 8° and 10° to 12° by puberty, respectively. The overall reported complication rate was 19.6%, with the most common complication being skin compromise in 8.2% of patients, followed by unacceptable angulation at the fracture site in 4.2% of patients and excessive limb shortening in 1.9% of patients.
conclusionThis article reviews the available spica casting literature and compiles the available data. Spica casting offers a safe, effective means for definitive management of paediatric diaphyseal femur fractures. Future research identifying the rate and pattern of remodelling as it relates to angulation and shortening at various patient ages, particularly beyond the aforementioned norms, would be valuable to identify true biological tolerances LEVEL OF EVIDENCE LEVEL II: Review of level II evidence.
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