Early spica treatment of pediatric femoral shaft fractures.

The purpose of this prospective study was to document results of early spica casting in treating all children aged 10 years or younger presenting during a 30-month period with a femoral shaft fracture. The outcome of 101 femoral shaft fractures thus treated demonstrated excellent results with few complications. Four spicas had to be removed at 7 to 10 days for unacceptable shortening and an additional four probably should have been. Control of alignment was not a problem, with only one patient's femur on cast removal being in a position different from that accepted at 7 to 10 days. An age older than 7 to 8 years is the only variable that might be used to predict the need for a change in treatment at 7 to 10 days.