THE TREATMENT OF PATHOLOGICAL FRACTURES O F THE LONG BONES IN CHILDREN BY MEANS OF ELASTIC STABLE INTRAMEDULLARY NAILING

Pathological or spontaneous fractures in childhood are rare and are mo stly caused by benign bone diseases; the fractures must be treated on an individual basis, as there are no constant rules. Since the new met hod of osteosynthesis called ''elastic stable intramedullary nailing'' (ESIN) or ''embrochage centro-medullaire elastique stable'' (ECMES) h as demonstrated the best results in the treatment of normal fractures in childhood, this method is rapidly being used in the treatment of sp ontaneous or pathological fractures. We report our experience in the t reatment of spontaneous fractures in childhood with ''elastic stable i ntramedullary nailing'', in nine patients with ten fractures. The path ological diagnosis was in 5 cases a juvenile bone cyst; in addition, t here were cases of histiocytosis X, lymphangiomatosis, hemangiomatosis and osteoporosis (one each). The location was the femur (two cases) a nd humerus (seven cases). All fractures healed completely without pseu darthrosis; as complications we saw one incidence of osteomyelitis, on e of a second fracture after ''elastic stable intramedullary nailing'' and one coxa vara in a child with histiocytosis X of the proximal fem ur. In the 5 children with juvenile bone cysts the nails are still in situ; in two cases the nails had to be changed.