Elastic, stable intramedullary nailing of pertrochanteric femoral fractures in children (<6–8 years)

Kaiser, N.; Slongo, T. (2021). Elastic, stable intramedullary nailing of pertrochanteric femoral fractures in children (<6–8 years). Operative Orthopädie und Traumatologie, 33(1), pp. 46-54. Springer 10.1007/s00064-020-00696-2

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Objective: Minimally invasive, sufficiently stable for movement and partial weight bearing, osteosythesis of pertrochanteric femoral fractures in children < 6-8 years using elastic, stable intramedullary nailing (ESIN).

Indications: Proximal, pertrochanteric femoral fractures Delbet type IV in children < 6 years.

Contraindications: Comminuted fractures, femoral neck fractures.

Surgical technique: By inserting three elastic titanium nails (TEN), prebent in the proximal third, retrograde into the femur, a stable 3‑point support stabilizes the proximal fragment. For further improvement of stability, EndCaps can be used.

Postoperative management: Partial weight bearing (sole-contact) for 4-5 weeks. X‑ray controls immediately after surgery and after 4-5 weeks. No sports for 3 months.

Results: In our patient population we have good experience with this technique for very rare pertrochanteric fractures in children younger than 6-8 years. With minimally invasive access, exercise-stable administration can be achieved without a pelvic leg cast.

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