title: Posteromedial elastic stable intra-medullary nailing (ESIN) in volarly displaced metaphyso-diaphyseal distal radius fractures in child.
abstract: BACKGROUND
  The distal metaphyso-diaphyseal fractures of the radius with volar angulation are generally considered unstable. Too distal to be treated with classic elastic stable intramedullary nailing (ESIN) via a laterodistal approach and too proximal to be stabilized with simple conservative treatment, they are sometimes treated by plating.
  
  
  METHODS
  To avoid the disadvantages of the open exposure necessary for this latter fixation and to prevent volar angulation while respecting the curvature of the radius, radial elastic nailing with posteromedial distal entry was used in 16 patients. These patients were reviewed with an average follow-up of 4.5 months.
  
  
  RESULTS
  Six patients presented a mean volar angulation of 7°, eight a mean posterior angulation of 5.5°, and two were aligned at 0°. On the AP view, seven patients presented a mean residual varus of 6.5°, four a mean residual valgus of 5°, and five were at 0°. The pronating curvature of the radius and the radioulnar index remained intact in all cases. One case of extensor digitorum tenosynovitis was observed and disappeared after wire removal.
  
  
  CONCLUSIONS
  For the unstable fractures of the distal third of the radius, certain authors propose systematic classic ESIN, but the lateral point of entry inevitably entails a varus misalignment, which is no longer the case if the entry is medial.
authors.affiliation: Saint Denis Regional hospital Center, CHR Réunion, 97405 Saint-Denis, France.
authors.forename: S
authors.initials: S
authors.lastname: Joulié
authors.forename: J M
authors.initials: JM
authors.lastname: Laville
authors.forename: F
authors.initials: F
authors.lastname: Salmeron
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D002648:Child; D018483:Diaphyses / Q000601:surgery*; D004548:Elasticity; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome