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Use of end caps in elastic stable intramedullary nailing of femoral and tibial unstable fractures in children: preliminary results in 11 fractures

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Background

Elastic stable intramedullary nailing (ESIN) is used routinely world-wide for treating femoral and tibial shaft fractures in children before skeletal maturity. Overall, ESIN allows rapid limb mobilisation with few complications. However, many centres have experienced some complications resulting from secondary fracture displacement, especially in heavy adolescents and in spiroid or complex fractures due to changes in the nail’s position, leading to limb shortening, malrotation and malalignment. End caps were designed by the AO expert group to address these complications.

Purpose

The purpose of this study is to evaluate the efficiency, safety and tolerance of this new device in our first series of ten patients and 11 fractures.

Methods

Prospective follow-up of our first ten patients operated on with end caps.

Results

Our results show that there were no serious complications at a mean follow-up of 13.1 months. There was only one 10-mm leg shortening in a patient in whom the end caps could not be properly inserted. There were no infections, no additional pain and no skin irritation. The use of end caps eased the removal of the nails after bone healing, thereby preventing the formation of ossification over the tips of the nails and appeared to protect the skin next to the nail tip.

Conclusion

These results seem to prove the advantage of using end caps when performing ESIN in lower limb shaft fractures in children. A longer follow-up that includes more patients and a randomised prospective study should be carried out in the future to determine more precisely the indications of this new device.

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Author information

Authors and Affiliations

  1. Service de Chirurgie Infantile, Unité de Traumatologie Infantile et Orthopédie Pédiatrique, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg Cedex, France

    E. Nectoux, M. C. Giacomelli, C. Karger, P. Gicquel & J. M. Clavert

Authors
  1. E. Nectoux
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  2. M. C. Giacomelli
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  3. C. Karger
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  4. P. Gicquel
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  5. J. M. Clavert
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Corresponding author

Correspondence to E. Nectoux.

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Nectoux, E., Giacomelli, M.C., Karger, C. et al. Use of end caps in elastic stable intramedullary nailing of femoral and tibial unstable fractures in children: preliminary results in 11 fractures. J Child Orthop 2, 309–314 (2008). https://doi.org/10.1007/s11832-008-0112-2

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  • DOI: https://doi.org/10.1007/s11832-008-0112-2

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