title: 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.
abstract: OBJECTIVE
  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°.
  
  
  CONCLUSIONS
  We advocate bending the tip of the nail at 180° before burying it in order to avoid skin irritation and additional procedures.
  
  
  METHODS
  Level III—retrospective comparative study.
authors.affiliation: Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Department of Paediatric Orthopaedics, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gibon
authors.affiliation: Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Department of Paediatric Orthopaedics, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France.
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Béranger
authors.affiliation: Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Department of Paediatric Orthopaedics, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France; The MAMUTH Hospital-University Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France.
authors.forename: Manon
authors.initials: M
authors.lastname: Bachy
authors.affiliation: Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Department of Paediatric Orthopaedics, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France; The MAMUTH Hospital-University Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Delpont
authors.affiliation: Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Department of Paediatric Orthopaedics, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France; The MAMUTH Hospital-University Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France.
authors.forename: Reda
authors.initials: R
authors.lastname: Kabbaj
authors.affiliation: Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Department of Paediatric Orthopaedics, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France; The MAMUTH Hospital-University Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, 26, avenue du Docteur Arnold Netter, F-75571 Paris Cedex 12, France. Electronic address: raphael.vialle@trs.aphp.fr.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Vialle
mesh_terms: D001858:Bone Nails / Q000009:adverse effects*; D002648:Child; D020878:Device Removal; D005260:Female; D005543:Forearm Injuries / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000295:instrumentation; D050723:Fractures, Bone / Q000601:surgery; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011885:Radius Fractures / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*
keywords: ESIN; Forearm fracture; Hardware removal; Skin impingement