title: Flexible Intramedullary Nailing of Unstable and/or Open Tibia Shaft Fractures in the Pediatric Population.
abstract: Tibial shaft fractures are common injuries in the pediatric population, and can be treated conservatively the vast majority of the time. Yet, it is important to recognize that open and/or unstable tibial shaft fractures represent a different entity. Rigid intramedullary devices are generally contraindicated because of the skeletal immaturity of these patients, and external fixation is associated with a high complication rate. As a result, flexible nailing is being utilized with increasing frequency. It is essential for the clinician to understand the pearls and pitfalls associated with the utilization of these flexible nails; particularly in regards to their immediate use in the context of open fractures and the risk of compartment syndrome postoperatively after fixation.
authors.affiliation: Department of Pediatric Orthopaedics, University of California San Francisco Benioff Children's Hospitals, Oakland, CA.
authors.forename: Nirav K
authors.initials: NK
authors.lastname: Pandya
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D002648:Child; D003161:Compartment Syndromes / Q000209:etiology / Q000517:prevention & control; D016267:External Fixators; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005597:Fractures, Open / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D011183:Postoperative Complications / Q000517:prevention & control*; D011859:Radiography / Q000379:methods; D013977:Tibia / Q000000981:diagnostic imaging / Q000293:injuries; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome