[Indications for intramedullary stabilization of shaft fractures in childhood. What is reliable, what is assumption?].

For some 15 years the elastically stable medullary nailing (ESIN) has been used in fracture treatment in children. The group of Nancy (Prevot and colleagues) first described the procedure for shaft fractures in children. Now the method is the standard procedure for stabilisation of long bone diaphyseal and metaphyseal fractures. During recent years a number of papers have described good and excellent results with this method, especially for shaft fractures of femur and forearm. In some papers there are also methods for articular fractures in more demanding techniques presented. Also when we have no evidence-based studies, we can say from the experience out of the last years that the ESIN is a biological, minimally invasive fracture treatment to achieve a high level of reduction and stabilisation in fractures in children. The use of titanium nails leeds to a higher rate of flexural elasticity and so the titanium nails are more recommended for this method.