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Intramedullary Nailing of Pediatric Long-Bone Fractures

Dorien Schneidmüller, MD, Mark Lehnert, MD, Marcus Maier, MD, Emanuel V Geiger, MD, and Ingo Marzi, PhD

Elastic stable intramedullary nailing (ESIN) has become a standard method of stabilizing pediatric long-bone fractures. Fracture stability is provided by a three-point buttress of two pre-bent, elastic, titanium nails that span the medullary canal, thus exerting opposing elastic forces. Small movements remain possible at the fracture site, supporting callus formation and bone union. ESIN is safe and minimally invasive, does not interfere with growth, and is associated with few complications, short hospital stays, and rapid return to daily activities. Severe complications are rare, with most problems arising from incorrect technique or indication. A comprehensive understanding of the principles, indications, and operating techniques is mandatory to obtain excellent results, but in experienced hands a broad spectrum of pediatric long-bone fractures can be treated using this method. Adv Orthop 2009;1(2):43–9.

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