Fig. (2) A 5.5-year-old boy who presented with a left closed transverse fracture of the femoral shaft due to a motor vehicle accident (high-energy trauma) and was initially treated with noninvasive traction for 9 days, followed by spica casting. (A) Preoperative radiograph. (B & C) Initial postoperative anteroposterior and lateral radiographs showing acceptable alignment. (D) Anteroposterior radiograph taken 15 days after spica casting showing loss of reduction (30° varus and >2-cm shortening). (E) Conversion to surgical fixation with flexible intramedullary nailing; the fracture subsequently healed without sequelae.