Transient femoral nerve palsy in spica cast treatment for developmental dysplasia of the hip

A 4 months and half female child come to our attention for congenital
dislocation of the left hip, previously treated in another hospital
with abduction bracing, without satisfactory results. After progressive
longitudinal bilateral traction, closed reduction under general
anesthesia was performed and a spica cast was applied in the
so-called human position. The patients remained in the spica cast for
6 weeks and then the plaster cast was renewed in narcosis for another
6 weeks. Once the second cast has been removed left femoral
nerve palsy was detected. Orthopaedic treatment was interrupted
and in 3 months the nerve completely recovered, while the hip was
still stable. We followed the child regularly since then, she is now
five years old, she is totally asymptomatic, X-rays shows a residual
acetabular dysplasia, with no sign of avascular necrosis.