Related Experiment Video
Updated: Oct 30, 2025
An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
Intramedullary Nailing of Paediatric Tibial Fractures: Comparison between Flexible and Rigid Nails
S Widbom-Kolhanen1, I Helenius1,2
1Department of Paediatric Orthopaedic Surgery, Turku University Hospital, University of Turku, Turku, Finland.
Insights
Rigid intramedullary nailing of tibial fractures offers better postoperative alignment and fewer malunions in children compared to flexible nailing. Younger children may benefit from flexible nails, while adolescents do better with rigid nails.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Intramedullary nailing is a common surgical technique for treating pediatric tibial fractures.
- Both flexible (elastic stable) and rigid intramedullary nails are used, each with potential advantages and disadvantages.
Purpose of the Study:
- To compare the patient characteristics and clinical outcomes of children with tibial fractures treated with rigid intramedullary nailing versus elastic intramedullary nailing.
- To evaluate the effectiveness of different intramedullary nailing techniques in achieving acceptable alignment and minimizing complications.
Main Methods:
- Retrospective review of 56 pediatric patients (26 flexible nailing, 30 rigid nailing) treated between 2008 and 2017.
- Analysis of demographic data, preoperative and postoperative radiographs (6-12 weeks and final follow-up), and complication rates.
Main Results:
- A higher proportion of patients treated with flexible nails had open proximal tibial physes (100% vs. 46.7%).
- Rigid nailing resulted in significantly better postoperative alignment (96.7% vs. 76.9%) and no malunions, compared to flexible nailing (23% malunion rate).
- Complication rates were similar between the two groups (15% flexible vs. 23% rigid).
Conclusions:
- Rigid intramedullary nailing is superior for achieving acceptable alignment and preventing malunion in pediatric tibial fractures.
- Elastic stable intramedullary nailing may be suitable for younger children with open proximal tibial physes, while rigid nailing is recommended for more mature adolescents.
Purpose:
To describe patient characteristics and to compare outcomes of children undergoing rigid intramedullary nailing of tibial fractures as compared with those operated on using elastic intramedullary nailing.
Methods:
A retrospective review of 26 children who have undergone flexible intramedullary nailing of tibial fractures and 30 children with rigid nailing at our university hospital between 2008 and 2017. The patient charts and radiographs were evaluated to identify demographic characteristics and several variables were measured preoperatively, as well as 6-12 weeks postoperatively in addition to final follow-up radiographs.
Results:
Twenty-six patients (26/26, 100%) treated with a flexible nail and 14 patients (14/30, 46.7%) treated with a rigid nail had open proximal tibial physis (p < 0.001). An acceptable postoperative alignment was obtained in 20 patients (20/26, 76.9%) in the elastic stable intramedullary nail group and in 29 patients (29/30, 96.7%) in the rigid group (p = 0.026). Some complications occurred in four patients (4/26, 15%) in the elastic stable intramedullary nail population and seven patients (7/30, 23%) in the rigid intramedullary nail population (p = 0.46). Malunion occurred in six patients (6/26, 23%) in the elastic stable intramedullary nail group and in none of the patients treated with a rigid intramedullary nail (p = 0.005).
Conclusion:
Younger children with tibial fractures who weight 50 kg or less and with proximal tibial growth plates wide open can be treated with elastic stable intramedullary nail while more mature adolescents benefit from rigid intramedullary nailing.
More Related Videos
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
05:34A Mini-Invasive Internal Fixation Technique for Studying Immobilization-Induced Knee Flexion Contracture in Rats
Published on: May 20, 2019
