Elastic Stable Intramedullary Nailing for Pediatric Long Bone Fractures: Experience with 175 Fractures

• Published in: Scandinavian journal of surgery Vol. 100; no. 3; pp. 208 - 215
• Main Authors: Furlan, D., Pogorelić, Z., Biočić, M., Jurić, I., Budimir, D., Todorić, J., Šušnjar, T., Todorić, D., Meštrović, J., Milunović, K. P.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2011
• Subjects: Adolescent; Bone Nails; Child; Child, Preschool; Female; Femoral Fractures - diagnostic imaging; Femoral Fractures - surgery; Fracture Fixation, Intramedullary - instrumentation; Fracture Healing; Humans; Humeral Fractures - diagnostic imaging; Humeral Fractures - surgery; Male; Pain Measurement; Postoperative Complications; Radiography; Radius Fractures - diagnostic imaging; Radius Fractures - surgery; Tibial Fractures - diagnostic imaging; Tibial Fractures - surgery; Titanium; Treatment Outcome; long bone; Elastic Stable Intra-medullary Nailing (ESIN); shaft fractures; Titanium Elastic Nail (TEN); diaphyseal fractures; pediatric
• ISSN: 1457-4969; 1799-7267
• DOI: 10.1177/145749691110000313

Purpose: To demonstrate the effectiveness of intramedullary fixation of displaced long bones shaft fractures in skeletally immature children using the elastic stable intramedullary nails. Patients and methods: The case records of 173 children who underwent fixation with titanium intramedulary nails because of long bones fractures were reviewed. The average age of the patients was 11.7 years, and mean follow-up was 41.3 months. There were 55 humeral, 42 forearm, 42 femoral and 36 tibial fractures. Subjective satisfaction was assessed. Results: All patients achieved complete healing at a mean of 7.5 weeks. Complications were recorded in 11 (6.3%) patients and included: one neuropraxia, six entry site skin irritations, two protrusions of the wires through the skin and two skin infections at the entry site. In a subjective measure of outcome at follow-up, 89% of patients were very satisfied and 11% satisfied; no patients reported their outcome as not satisfied. The implants were removed at a median time of six months from the index operation. Conclusion: Elastic Stable Intra-medullary Nailing is the method of choice for the pediatrics patients, because it is minimaly invasive and shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction.