Infant Femur Fracture
Limited evidence supports treatment with a Pavlik harness or a spica cast for infants six months and younger with a diaphyseal femur fracture, because their outcomes are similar.
The first 6 months of a child’s life is a time of most rapid growth. Because of this, rapid healing of diaphyseal femur fractures and post-fracture skeletal remodeling is maximal. Hence spontaneous, complete correction after fracture healing is expected. Due the rapid union and complete remodeling, treatment of diaphyseal femur fractures centers on assuring ease of patient care and minimizing treatment complications. Both Pavlik harnesses and spica casts result in good outcomes with minimal complications. In the studies we reviewed, the only identifiable difference between these two treatments was more frequent skin complications in the spica cast group. Because this is a minor and correctable issue that does not cause long-term problems or disability, either type of treatment is an option.
- (17) Podeszwa DA, Mooney JF, III, Cramer KE, Mendelow MJ. Comparison of Pavlik harness application and immediate spica casting for femur fractures in infants. J Pediatr Orthop. 2004;24:460-462.
- (18) Stannard JP, Christensen KP, Wilkins KE. Femur fractures in infants: a new therapeutic approach. J Pediatr Orthop. 1995;15:461-466.