Socio-professional impact of the hip spica cast for femoral shaft fracture management in children under six - 30/11/25

Doi : 10.1016/j.otsr.2025.104556

Edouard de Charnace ^a,⁎ , Iseut Line Bunetel ^a, Margaux Haas ^a, Charles Senah ^a, Mohammed Belouadah ^a, Mohamed Mehrez Kilani ^a, Delphine Tuton ^a, Sophie Bourelle ^a,^b

^a Department of Pediatric Surgery, American Memorial Hospital, Reims, France

^b Reims Champagne-Ardenne University, France

^⁎ Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 30 November 2025

Abstract

Background

The treatment of a femoral shaft fracture in children under the age of 6 years old consists in a closed reduction followed by a hip spica cast, which can have a major impact on the family. The aim of this study is to assess the socio-professional impact of the hip spica cast (HSC) on families.

Materials and methods

Families of 114 children under 6 years of age treated with a hip spica cast for a femoral shaft fracture were surveyed using a questionnaire created for this study. Additional clinical data were collected on treatment, hospitalization and duration of immobilization.

Results

Within the 114 patients included, the mean age was 2.7 years, and the mean duration of immobilisation was 6.6 weeks. The difficulties encountered by the parents in managing the cast were evaluated at 7 out of 10 scale (from 0 very easy to 10 very difficult). Difficulties were significantly greater in relation to the duration of immobilisation and the age of the child (p < 0.05). In 47% of cases, one or both parents had to take time off work. Taking time off work was not correlated with the duration of immobilisation or the age of the child. Families with both parents working (or single parents working) were out of work more often and for longer periods than those with at least one parent at home (p < 0.05). After removal of the immobilisation, 71% of the children had returned to walking within a month.

Conclusions

The treatment with hip spica cast has a major socio-economic impact, particularly in terms of parental time off work. However, it is the reference treatment for femoral shaft fractures in children under 6 years of age, with very good results.