genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2021-27-4-413-417genort-23Research ArticleОригинальные статьиOriginal articlesПрименение эластичных стержней при диафизарных переломах у детей. Пять вопросов и ответовUse of flexible nails in children diaphyseal fractures. Five questions and answersLascombesP.LascombesP.

Pierre Lascombes, Honorary Professor, Nancy;

Past Professor, Geneva

Pierre Lascombes, Honorary Professor, Nancy;

Past Professor, Geneva

pierrelascombes@gmail.comJourneauP.JourneauP.

Pierre Journeau, M.D., 

Nancy

Pierre Journeau, M.D.,

Nancy

dpopkov@mail.ruhttps://orcid.org/0000-0002-8996-867XPopkovD. A.PopkovD. A.

Dmitry A. Popkov, M.D., Ph.D., Professor of RAS, correspondent member French Academy of Medical Sciences,

Kurgan

Dmitry A. Popkov, M.D., Ph.D., Professor of RAS, correspondent member French Academy of Medical Sciences,

Kurgan

dpopkov@mail.ruUniversity of Nancy; University of GenevaФранцияUniversity of Nancy; Geneva University HospitalsFranceChildren hospitalФранцияChildren hospitalFranceIlizarov National Medical Research Centre for Traumatology and OrthopedicsРоссияIlizarov National Medical Research Centre for Traumatology and OrthopedicsRussian Federation202128082021274№ 4 (2021)413417Copyright © Lascombes P., Journeau P., Popkov D.A., 20212021Lascombes P., Journeau P., Popkov D.A.Lascombes P., Journeau P., Popkov D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/23Введение

Введение. Прошло более 40 лет с момента начала применения эластичного стабильного интрамедуллярного стержня (ESIN) в качестве «золотого» стандарта лечения некоторых переломов у детей и подростков.

Материалы и методы

Материалы и методы. Обзор основан на ответах на пять основных вопросов: положение ESIN относительно других методов лечения; выбор имплантатов; показания к применению ESIN сегодня; как максимально возможно избежать осложнений? Удалять имплантаты или нет?

Результаты

Результаты. В статье представлены аспекты биомеханики, дизайн, показания к применению ESIN по сравнению с другими методами лечения, хирургические методы в зависимости от типа перелома костей, осложнений.

Заключение

Заключение. ESIN – отличный метод лечения переломов длинных костей у детей и подростков. Верхняя конечность – это, безусловно, переломы обеих костей предплечья, нижняя - диафизарные переломы бедренной и большеберцовой костей до достижения возраста, когда можно использовать фиксирующий гвоздь. Однако некоторые нестабильные переломы нельзя лечить ни консервативно, ни с помощью фиксирующего гвоздя, и тогда при нестабильной фиксации ESIN мы можем предложить усилить конструкцию внешним фиксатором на 4–6 недель, ожидая хорошей стабилизации перелома. 

Introduction

Introduction. More than 40 years after the launch of elastic stable intramedullary nailing (ESIN) as a golden standard of the treatment of some fractures in children and adolescents.

Material and methods

Material and methods. This review is based on answers to five essential questions: The position of ESIN compared with other methods of treatment; The choice of the implants; The indications for ESIN today; How to avoid complications as much as possible? Do we remove the implants or not?

Results

Results. The aspects of biomechanics, design, indications for ESIN in comparison to other treatment, surgical techniques depending on fractured bones, complications are presented in the article.

Conclusion

Conclusion. ESIN is an excellent method to fix long bone fractures in children and adolescents. Top one is definitively the fractures of both bones of the forearm, then the diaphyseal fractures of the femur and the tibia before the age to be eligible for a locking nail. However, some unstable fractures cannot be treated conservatively or with a locking nail, and an ESIN remains unstable. In these cases, we are allowed to propose to add an external fixator for 4 to 6 weeks, waiting for a good stabilisation of the fracture.

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The authors declare that there are no conflicts of interest present.