OUTCOMES OF PEDIATRIC TIBIAL SHAFT FRACTURES USING ELASTIC STABLE INTRAMEDULLARY NAILING
Main Article Content
Abstract
Background: Elastic stable intramedullary nailing (ESIN) remains a widely accepted treatment option for tibial shaft fractures in children. Objective: To evaluate the treatment outcomes of pediatric tibial shaft fractures managed with elastic stable intramedullary nailing. Materials and methods: A prospective single-arm interventional study was conducted on 29 pediatric patients aged 7 to 15 years who were treated at the Department of Orthopedics, Can Tho Children’s Hospital, from March 2025 to February 2026. Results: The bone union rate at 3 months was 79.31%. Postoperative limb length discrepancy was less than 1 cm in 100% of cases. Angular deformity of less than 5° was 82.76%. According to the Flynn criteria, overall outcomes were excellent in 79.31% and good in 20.69% of cases, with no poor outcomes recorded. Conclusion: Elastic stable intramedullary nailing under fluoroscopic is a safe and effective method for the management of pediatric tibial shaft fractures.
Keywords
Elastic stable intramedullary nailing (ESIN), tibial shaft fractures in children, Flynn criteria
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
2. Huỳnh Trung Hiếu và Võ Quang Đình Nam. Đánh giá kết quả điều trị gãy kín thân xương đùi trẻ em bằng đinh nội tủy Metaizeau dưới màn tăng sáng. Tạp chí Y Dược học Cần Thơ. 2023. 68(2023), 80-88.
3. Shu W. A novel pre-bending tool for elastic stable intramedullary nailing: An efficient and accurate study. J Child Orthop. 2023 Aug 18;17(5):453-458. doi:10.1177/18632521231193713.
4. Qureshi KK. Outcome of Elastic Stable Intramedullary Nailing (ESIN) for tibia fractures in children. Professional Med J. 28(1), 16-21, doi:10.29309/TPMJ/2021.28.01.5818.
5. Pogorelić Z. Elastic Stable Intramedullary Nailing for Treatment of Pediatric Tibial Fractures: A 20-Year Single Center Experience of 132 Cases. Children (Basel). 2022. 9(6), 845, doi:10.3390/children9060845.
6. Fanelli D. Outcomes and complications following flexible intramedullary nailing for the treatment of tibial fractures in children: a meta-analysis. Arch Orthop Trauma Surg. 2022.142(7), 1469-1482, doi:10.1007/s00402-021-03839-7.
7. Hong P. External fixation versus elastic stable intramedullary nailing in the treatment of open tibial shaft fractures in children. J Orthop Surg Res. 2021. 16(1), 528, doi:10.1186/s13018-02102679-w.
8. Maciejewski M. Treatment of Unstable Tibia Shaft Fractures in Children With Elastic Stable Intramedullary Nails or Minimally Invasive Plate Osteosynthesis: Comparative Study on 2 Treatment Options. J Pediatr Orthop. 2026. 46(1), 1-5, doi:10.1097/BPO.0000000000003077.
9. Gupta RK. A clinical study on Titanium elastic nail system in the treatment of diaphyseal tibial fracture in paediatric age group. Int J Life Sci Biotechnol Pharma Res. 2024. 13(5), 557-561.
10. Sankar WN. Titanium elastic nails for pediatric tibial shaft fractures. J Child Orthop. 2007. 1(5), 281-6, doi:10.1007/s11832-007-0056-y.
11. Karaman I. Mid-term results of the elastic intramedullary nailing in paediatric long bone shaft
fractures. Journal of Pediatric Orthopaedics B. 2014. 23(3), 212–220, doi:10.1097/01.bpb.0000444460.
12. Başaran SH. The titanium elastic nailing in pediatric tibia fractures caused pedestrian versus motor vehicle accidents. Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy. 2016. doi:10.5350/BTDMJB201612403.
13. Uludağ A. Treatment of Unstable Pediatric Tibial Shaft Fractures with Titanium Elastic Nails. Medicina. 2019. 55(6), 266, doi:10.3390/medicina55060266
14. Khan AQ. Titanium elastic nail system in compound tibial fractures in children and adolescents. Int J Burns Trauma. 2025. 15(1), 11-20, doi:10.62347/WMXS7935.