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Elastic stable IM nails may yield positive results for pediatric long-bone fractures
Griffet J. J Child Orthop. 2011. doi: 10.1007/s11832-011-0343-5
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Elastic stable intramedullary nailing can deliver normal knee mobility and symmetrical foot progress for pediatric patients with long-bone closed fractures, according to this study from French researchers.
The technique’s advantages, the authors claim, include reduced infection and re-fracture rates, ease of management and an “aesthetically pleasing” scar.
In this 6-year study, the authors investigated the use of elastic stable intramedullary nailing (ESIN) in children older than 6 years who had displaced tibial fractures. The team measured frontal and sagittal angulation, as well as shortening and lengthening on days 0, 2, 15, 30 and 45. Assessments of the femoro-tibial axis as well as eventual shortening or lengthening were all assessed at the 6-month, 1-year and 2-year marks.
The cohort consisted of 86 children with an average age of 11.8 years. All patients demonstrated normal knee mobility and symmetrical foot progress angle by day 30, with 2-year follow-up revealing that frontal angulation and leg length discrepancy decreased, and impacted 2% of patients.
“Four patients (5%) suffered from superficial infections,” the authors wrote. “There were no cases of osteomyelitis or re-fracture.”