In pediatric femur fractures, spica casting is favored for which type of fracture?

• A. Unstable fractures
• B. Open fractures
• C. Fractures in elderly
• D. Stable fractures

Answer: (D)

Spica casting is most appropriate when the fracture is stable and can be kept in proper alignment with immobilization alone. In children, after closed reduction, a hip-spica cast provides rigid immobilization of the femur from trunk to foot, allowing healing while avoiding surgery. The bones in kids remodel well, so maintaining alignment with a cast often suffices for diaphyseal femur fractures that are not displaced or destabilized. In contrast, unstable fractures tend to redisplace despite casting and usually need surgical stabilization; open fractures require immediate soft-tissue management and cannot be adequately treated with a cast; and fractures in elderly patients fall outside pediatric practice.