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

Bitar Km,Ashraf Ei,Ferdhany Me,Saw A

doi:10.5704/moj.1611.008

Bitar Km, Ashraf Ei + Show 2 more

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https://doi.org/10.5704/moj.1611.008

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Abstract

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.

Highlights

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
Most publications reporting the use of hip spica cited the technique described by Kumar in 1981 where multiple strips of plaster of paris (POP) slabs were applied across the joints and limbs 2
Especially at the femoral pelvic junction, is a common problem with the use of hip spica cast with POP material; this why some authors developed modifications of the standard technique to improve the durability, including application of a cross bar connecting both the lower limb components 3

Summary

INTRODUCTION

Hip spica casting is a common treatment method for a variety of conditions that requires immobilization of the femur and pelvis 1 They include femur fracture in young children, proximal femur osteotomy, septic arthritis of the hip and developmental dysplasia of the hip (DDH). Especially at the femoral pelvic junction, is a common problem with the use of hip spica cast with POP material; this why some authors developed modifications of the standard technique to improve the durability, including application of a cross bar connecting both the lower limb components 3. By modifying the placement of these slabs, we hoped to improve the strength of spica cast across the femoral pelvic junction to protect against breakage Both plaster of paris (POP) and synthetic fiberglass material have been used for hip spica casting 4. The purpose of this study was to evaluate the physical outcome of hip spica applied with our modified technique using fibreglass as cast material, and evaluate the clinical outcome of this procedure including clinical complications and short term stability of the hip after removal of cast

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