Der Unfallchirurg
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The conservative treatment of pediatric femoral fractures can be socially and financially burdensome for patients 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. ⋯ 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 femoral fractures. The leg length discrepancy 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.