The Treatment of Supracondylar Humeral Fractures With Elastic Stable Intramedullary Nailing (ESIN) in Children

Abstract

IV.

Treatment of fifth metacarpal neck fractures with antegrade single elastic intramedullary nailing

“…The single elastic nail acted on a three point intramedullary fixation providing adequate stability. Elastic stable intrumedullary nail had been established as the gold standard in the treatment of displaced and/or unstable diaphyseal fractures of the long bones and special metaphyseal fractures [19]. Collectively, the advantages of antegrade single elastic intramedullary nailing approach included (1) minimally invasive percutaneous techniques, (2) minimal trauma, (3) no affection on joint capsule, which is good for the joint function recovery, (4) accelerated fracture healing, (5) no influence on the extensor tendon.…”

Elastic Stable Intramedullary Nailing (ESIN) of Pediatric Metacarpal Fractures: Experiences with 66 Cases

“…ESIN has been established as the gold standard in the treatment of displaced and/or unstable diaphyseal fractures of the long bones and special metaphyseal fractures such as the radial neck and supracondylar area in children. [5][6][7] Advantages of this minimally invasive technique, such as the castless postoperative treatment, have transferred indications also to the small bones of foot and hand, including the metacarpals. 8 In principle, this technique has been described previously in adult metacarpals, but Kirschner (K)-wires were used as implants requiring additional immobilization at least in the initial postoperative course.…”

“…Advantages of this technique include minimal invasiveness, less postoperative pain, immobilization-free treatment until fracture consolidation, and rapid return to daily activities. [5][6][7] Thus, ESIN of the short bones has become increasingly established as method of choice in fractures that warrant surgical intervention. Nevertheless, this procedure in short bones of the hand has not as extensively been cited in the literature as in long bones.…”

The displaced supracondylar humerus fracture

“…A retrospective study by Lacher et al [52] investigated the short-term outcome of supracondylar fractures stabilized with ESIN and concluded that this technique is suitable for all types of supracondylar fractures in children with good functional results. Postoperatively, immobilization is required until pin removal, which may cause additional discomfort for the child.…”