We treated 20 children for an isolated femoral shaft fracture using distal tibial traction incorporated into a spica cast with the knee in full extension. Patients were discharged from the hospital at a mean of 5.1 days following injury. All fractures healed, and there were four minor complications. At a mean follow-up of 35 (13–72) months, all patients were asymptomatic with normal function. All but one fracture healed in acceptable alignment, and there was no clinically significant leg-length discrepancy. The method is relatively simple to employ and may be advantageous in a setting of limited resources.
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