[Elastic Stable Intramedullary Nailing (ESIN) of Metatarsal Fractures]

Area of Science:

• Orthopedic surgery
• Traumatology
• Minimally invasive procedures

Background:

• Displaced metatarsal fractures often require surgical intervention for optimal functional recovery.
• Traditional fixation methods like plate fixation or retrograde pinning carry risks of soft tissue irritation, joint stiffness, and complications.
• Elastic stable intramedullary nailing (ESIN) presents an alternative minimally invasive approach.

Purpose of the Study:

• To evaluate the safety and efficacy of antegrade, minimally invasive elastic stable intramedullary nailing (ESIN) using titanium elastic nails (TEN) for short metatarsal shaft and neck fractures.
• To assess the functional outcomes and complication rates associated with this technique.

Main Methods:

• A retrospective analysis of 22 patients who underwent ESIN for short metatarsal fractures over a 7-year period.
• Detailed presentation of the surgical technique.
• Functional outcomes and complications were evaluated using the AOFAS Midfoot Score.

Main Results:

• Nineteen patients were analyzed with an average follow-up of 25.6 months.
• The mean AOFAS score was 93.9, indicating excellent functional results.
• No cases of pseudarthrosis, secondary fracture dislocation, or nail breakage were observed. One patient required TEN shortening for skin irritation.

Conclusions:

• Antegrade ESIN with TEN is a safe and effective surgical treatment for short metatarsal shaft and neck fractures.
• The technique provides primary functional stability, promotes reliable fracture healing, and yields good functional outcomes.
• This minimally invasive approach avoids complications associated with other fixation methods.