[Therapy of pediatric XXXX : Two versus three elastic stable intramedullary nails.]

@entity1 @entity3656 @entity3330
BACKGROUND: The conservative treatment of pediatric @entity3330 can be socially and financially burdensome for @entity1 and families due to the long period of immobilization. New operative techniques have consistently gained significance in the treatment of such fractures due to a shorter period of immobilization. Elastic stable intramedullary nailing (ESIN) in particular has been proven to lead to better outcome in comparison to conservative treatment. This article presents the first study that compares the outcome of three versus two ESINs in the treatment of pediatric femoral shaft fractures. MATERIAL AND METHODS: A retrospective analysis of all @entity1 who underwent operative treatment of @entity3330 with ESINs in our hospital from 2009-2012 was carried out. A follow-up examination was performed in mid-2013 by standardized evaluation of @entity3656 and the movement capacity of the hip and knee joint. RESULTS: The follow-up examination revealed a @entity3656 of the injured leg when three ESINs were used (p   =   0.013) and an impairment of the movement capacity in the hip joint of the injured leg (p   =   0.029). In addition the surgery time for metal removal of three ESINs was higher (p   =   0.046). All other evaluated parameters did not show any differences. CONCLUSION: In this study population the treatment of pediatric femoral shaft fractures with three ESINs showed no benefit in comparison to two ESINs and therefore should not be used to treat @entity3330 . The @entity3656 using three ESINs may be explained by a nonsymmetrical distribution of support points leading to an increased micromovement of the bone with increased callus formation.
