Objective:

To compare the outcomes of elastic stable intramedullary nailing (ESIN) with hip spica casting for managing postoperative femoral fractures in children with developmental dysplasia of the hip (DDH).

Approach:

Key Findings:

• Significant differences in age and fracture pattern were observed between the two groups (P < 0.001).
• The average length of hospitalization was longer in the hip spica casting group (9.5 days) compared to the ESIN group (6.4 days, P < 0.001).
• Surgical time was shorter in the hip spica casting group (24.8 ± 4.5 min) than in the ESIN group (34.7 ± 5.1 min, P < 0.05).

Interpretation:

Radiological outcomes were generally good after both ESIN and hip spica casting.

Limitations:

• Study included a small sample size of 18 patients.
• Exclusion of patients with incomplete medical records or follow-up time of <24 months.

Conclusion:

Hip spica casting was indicated for undisplaced femoral fractures in patients aged 2–5 years, while ESIN was indicated for displaced femoral fractures in patients aged 5–8 years.

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