Multicenter retrospective study (n=215) comparing immediate spica casting to titanium elastic nailing (TEN) for diaphyseal femur fractures in children aged 2–6 years, asking whether surgical fixation offers functional advantages over the traditional non-operative standard in this age group.
When you see a femur fracture in a 2–6 year old with high-energy mechanism, polytrauma, or a family situation where spica immobilization is impractical (single-parent household, daycare requirements), TEN is a defensible alternative to spica casting — expect ambulation ~3 weeks earlier with equivalent union rates and a second trip to the OR for nail removal in most cases.
Multicenter retrospective study (n=215) comparing immediate spica casting to titanium elastic nailing (TEN) for diaphyseal femur fractures in children aged 2–6 years, asking whether surgical fixation offers functional advantages over the traditional non-operative standard in this age group.
When you see a femur fracture in a 2–6 year old with high-energy mechanism, polytrauma, or a family situation where spica immobilization is impractical (single-parent household, daycare requirements), TEN is a defensible alternative to spica casting — expect ambulation ~3 weeks earlier with equivalent union rates and a second trip to the OR for nail removal in most cases.