[Complications and errors in use of intramedullary nailing in shaft fractures in childhood].

Abstract

Elastic stable intramedullary nailing (ESIN) is well established for stabilizing pediatric diaphyseal fractures. Indications are all femur shaft and instable diaphyseal forearm fractures, selected instable lower leg and malaligned humerus fractures. Intraoperative problems (6.5%) include the need for open reduction, cortical perforation by a nail tip and bursting of a third fragment. Postoperative problems (6.4%) are mainly induced by skin irritation at the place of implantation. Complications (8.4%) result from wrong indication with subsequent malalignment and instability. Re-fractures are seldom seen. Typical iatrogenic nerve injuries (superficial radial nerve) need technical variation. Prevention of most complications and mistakes requires the exact consideration of guidelines for indication and technique even in a supposed easy procedure.