Physical and Clinical Evaluation of Hip Spica Cast applied with Three-slab Technique using Fibreglass Material

Introduction: Hip spica casting is an important component of treatment for developmental dysplasia of the hip (DDH) and popular treatment method for femur fractures in children. Breakage at the hip region is a relatively common problem of this cast. We have developed a three-slab technique of hip spica application using fibreglass as the cast material. The purpose of this review was to evaluate the physical durability of the spica cast and skin complications with its use. Methodology: A retrospective review of children with various conditions requiring hip spica immobilisation which was applied using our method. Study duration was from 1st of January 2014 until 31st December 2015. Our main outcomes were cast breakage and skin complications. For children with hip instability, the first cast would be changed after one month, and the second cast about two months later. Results: Twenty-one children were included, with an average age of 2.2 years. The most common indication for spica immobilisation was developmental dysplasia of the hip. One child had skin irritation after spica application. No spica breakage was noted. Conclusion: This study showed that the three-slab method of hip spica cast application using fibreglass material was durable and safe with low risk of skin complications.

Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture

The complications following paediatric femur fracture are leg length discrepancy, angulation deformity, rotational deformity, ischemic limb. But, stiff knee is rarely expressed after trauma like paediatric femur fracture. We report a case of stiff knee due to entrapment of quadriceps femoris tendon at displaced fracture site after conservative treatment by Russel traction and hip spica cast in paediatric femur fracture. We treated successfully by resection of distal end of proximal segment of femur and release of quadriceps femoris tendon for flexion contracture of the knee.

Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture

The complications following paediatric femur fracture are leg length discrepancy, angulation deformity, rotational deformity, ischemic limb. But, stiff knee is rarely expressed after trauma like paediatric femur fracture. We report a case of stiff knee due to entrapment of quadriceps femoris tendon at displaced fracture site after conservative treatment by Russel traction and hip spica cast in paediatric femur fracture. We treated successfully by resection of distal end of proximal segment of femur and release of quadriceps femoris tendon for flexion contracture of the knee.