Abstract

Elastic stable intramedullary nailing is the ideal internal fixation in children; the technique is not aggressive and the physiological periosteal consolidation is respected. This treatment is complementary to the conservative approach. The authors report their experience in 20 patients, aged 4 to 17 years. Primary instability (16 cases) and repeated fractures (3 cases) were the main indications. The operative technique is described. Open reduction was necessary for one or both forearm bones in 9 children. There were technical problems, but without consequences for the consolidation, which was always complete after 2 1/2 months, without cast immobilization. In all patients, the function was normal after 2 months. There were no serious complications. The fixation material should not be removed during the first postoperative year, in order to prevent refractures.