Influence of the bending of the tip of elastic stable intramedullary nails on removal and associated complications in pediatric both bone forearm fractures: a pilot study.

OBJECTIVES: Both bone forearm fractures are efficiently treated by elastic stable intramedullary nail (ESIN). According to the original technique, the tip of the nail must be bent at 90° and buried under the skin. However, skin irritation is commonly reported and may lead to early surgery to shorten the tip or remove the hardware. The purpose of this study was to investigate the influence of the bending of the tip of the nail in this procedure.

METHODS: We retrospectively reviewed 72 children operated on using this technique with the tip bent either at 90° or at 180°. In both groups we recorded complication rates after the procedure and at the removal.

RESULTS: Time until removal and duration of the removal were similar in both groups. Three complications (6.7%) that required additional surgery were recorded when the tip was bent at 90° whereas no complications were found with the tip bent at 180°.

CONCLUSION: We advocate bending the tip of the nail at 180° before burying it in order to avoid skin irritation and additional procedures.

LEVEL OF EVIDENCE: Level III—retrospective comparative study.