title: Three-point fixation walking spica cast: an alternative to early or immediate casting of femoral shaft fractures in children.
abstract: A retrospective review of 28 children treated for middle and proximal femoral shaft fractures was undertaken. Following preliminary traction, a modified pantaloon walking spica, utilizing the principle of total contact and three-point fixation molding, was applied, followed by immediate ambulation. The mean anterior bow was 5 degrees varus/valgus, 6.5 degrees angulation, and 1.2 cm shortening. There were no significant differences in the results when age groups or proximal to mid-shaft fractures were compared. No further shortening or angulation occurred with ambulation. The advantages of early ambulation and better control of proximal shaft fractures are discussed.
authors.affiliation: Department of Orthopedic Surgery, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
authors.forename: G G
authors.initials: GG
authors.lastname: Guttmann
authors.forename: R
authors.initials: R
authors.lastname: Simon
mesh_terms: D000293:Adolescent; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D004434:Early Ambulation; D005260:Female; D005264:Femoral Fractures / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007870:Leg Length Inequality / Q000503:physiopathology; D008124:Locomotion; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D014945:Wound Healing