Tibial Shaft Fracture: Flexible Nails

  • Oussama Abousamra
  • Julieanne P. Sees
Living reference work entry


A 12-year-old boy sustained an injury to his left leg due to a car accident. Distal neurovascular status of the left lower extremity was intact and the extremity had no open wounds. On radiographic evaluation he was found to have a mid-shaft oblique tibia fracture, with malrotation and shortening. Under fluoroscopy an attempt was made to reduce the fracture; however, the fracture was found to be unstable. Subsequently the patient was taken to the operative room for operative intervention requiring internal stabilization with flexible nailing. He was placed nonweight bearing in a short leg cast for 3 weeks. After radiographs showed adequate healing, he was allowed to weight bear as tolerated for 3 weeks in a camboot. At 6 weeks from surgery with complete union present on radiographs and no pain, he was allowed to fully weight bear as tolerated. Six weeks later, he was evaluated clinically and found to be pain free with full motion; therefore, he was allowed to return to all activities with no restrictions. At 10 months postoperatively, he elected for intramedullary nail removal which was completed without any complications.

Suggested Reading

  1. Goodbody CM, Lee RJ, Flynn JM, Sankar WN (2016) Titanium elastic nailing for pediatric tibia fracture: do older, heavier kids do worse? J Pediatr Orthop 36(5):472–477CrossRefPubMedGoogle Scholar
  2. Gordon JE, Gregush RV, Schoenecker PL, Dobbs MB, Luhmann SJ (2007) Complications after titanium elastic nailing of pediatric tibial fractures. J Pediatr Orthop 27(4):442–446CrossRefPubMedGoogle Scholar
  3. Lascombes P, Huber H, Fay R, Popkov D, Haumont T, Journeau P (2013) Flexible intramedullary nailing in children: nail to medullary canal diameters optimal ratio. J Pediatr Orthop 33(4):403–408CrossRefPubMedGoogle Scholar
  4. Pandya NK (2016) Flexible intramedullary nailing of unstable and/or open tibia shaft fractures in the pediatric population. J Pediatr Orthop 36(Suppl 1):S19–S23CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Nemours Alfred I. duPont Hospital for ChildrenWilmingtonUSA

Section editors and affiliations

  • Eric D. Shirley
    • 1
  1. 1.Pediatric Orthopaedic AssociatesAltantaUSA

Personalised recommendations