Elastic stable intramedullary nailing in the treatment of op
This study aims to compare the clinical outcomes of EF vs. ESIN in the treatment for open tibial shaft fracture in children retrospectively. External fixator (EF) is a popular choice for open tibial fractures, but pin tract infection (PTI) and refracture are common complications. Elastic stable intramedullary nail (ESIN) has been reported in the treatment for open tibial fractures.

Patients aged 5–11?years with Gustilo-Anderson II and IIIA tibial shaft fracture were reviewed retrospectively and categorized into EF and ESIN groups. Patients with pathological fracture, neuromuscular disorder, metabolic disease, previous tibial fracture or instrumentation, and polytrauma were excluded.

Results:
--In all, 55 patients were included in the EF group, whereas 37 patients were included in the ESIN group. There was no statistically significant difference between the two groups concerning sex, age, body weight, duration from injury to surgery, Gustilo-Anderson (GA) classification, and concomitant injuries.

--There was no case of nonunion and malunion in either group.

--The angulation at the latest follow-up was higher in the EF group than the ESIN group. The radiological union was faster in the ESIN group than those in the EF group.

--Limb length discrepancy (LLD) was more in the EF group than in the ESIN group.

Finally, in selected patients with GA grade II and IIIA open tibial fractures, ESIN is a viable choice with equivalent clinical outcomes to an external fixator. The most troublesome consequence in the EF group is pin tract infection, while implant prominence is a concern in the ESIN group.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02679-w
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