[Treatment of pathological fractures of long tubular bones in childhood using elastic stable intramedullary nailing].

Pathological or spontaneous fractures in childhood are rare and are mostly caused by benign bone diseases; the fractures must be treated on an individual basis, as there are no constant rules. Since the new method of osteosynthesis called "elastic stable intramedullary nailing" (ESIN) or "embrochage centro-medullaire elastique stable" (ECMES) has demonstrated the best results in the treatment of normal fractures in childhood, this method is rapidly being used in the treatment of spontaneous or pathological fractures. We report our experience in the treatment of spontaneous fractures in childhood with "elastic stable intramedullary nailing", in nine patients with ten fractures. The pathological diagnosis was in 5 cases a juvenile bone cyst; in addition, there were cases of histiocytosis X, lymphangiomatosis, hemangiomatosis and osteoporosis (one each). The location was the femur (two cases) and humerus (seven cases). All fractures healed completely without pseudarthrosis; as complications we saw one incidence of osteomyelitis, one of a second fracture after "elastic stable intramedullary nailing" and one coxa vara in a child with histiocytosis X of the proximal femur. In the 5 children with juvenile bone cysts the nails are still in situ; in two cases the nails had to be changed.