Clinical Report: Comparison of ESIN and Hip Spica Casting for Femoral Fractures

Overview

This study compares the outcomes of elastic stable intramedullary nailing (ESIN) and hip spica casting for managing postoperative femoral fractures in pediatric patients with developmental dysplasia of the hip (DDH). Significant differences were found in hospitalization duration and surgical time between the two treatment methods.

Background

Proximal femoral osteotomy (PFO) is commonly performed to correct proximal femoral deformities in children with DDH. Postoperative femur fractures can occur, necessitating effective management strategies. The choice between ESIN and hip spica casting remains unclear.

Data Highlights

Key Findings

• 18 patients with postoperative femur fractures were included in the study.
• Significant differences in age and fracture pattern were noted (P < 0.001).
• Average hospitalization was longer for hip spica casting compared to ESIN (9.5 days vs. 6.4 days, P < 0.001).
• Surgical time was shorter for hip spica casting than for ESIN (24.8 min vs. 34.7 min, P < 0.05).
• Hip spica casting is suggested for undisplaced femoral fractures in patients aged 2–5 years.
• ESIN is recommended for displaced femoral fractures in patients aged 5–8 years.

Clinical Implications

The findings suggest that hip spica casting may be more suitable for younger patients with undisplaced fractures, while ESIN offers a quicker and less invasive option for older children with displaced fractures. Clinicians should consider these factors when determining treatment strategies.

Conclusion

Both ESIN and hip spica casting yield good radiological outcomes for postoperative femoral fractures in children with DDH.

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