We report the use of elastic stable intramedullary naffing (ESIN) in 123 fractures of the femoral shaft in children. Flexible rods are introduced through the distal metaphyseal area, and the aim is to develop bridging callus. Early weight-bearing is possible and is recommended. There was one case of bone infection and no delayed union. Complications were minimal, the most common being minor skin ulceration caused by the ends of the rods. A surprising feature was the low incidence of growth changes, with a mean lengthening of only 1.2 mm after an average follow-up of 22 months. Compared with conservative treatment, ESIN obviates the need for prolonged bed rest and is thus particularly advantageous for treating children.

No abstract

The good results of this reliable technique are obtained when surgeons have a good knowledge of it, especially in the understanding of the principle of the correction of the fracture and its stability.

No abstract

No abstract

These data demonstrate that idiopathic scoliosis indeed alters balance control, with different hierarchies, from the best to the worst as follows: double major, thoracic, thoracolumbar, and lumbar curves in the static test and double major, lumbar, thoracolumbar, and thoracic curves in the slow dynamic test. The location of the major curve appeared to be important, with an effect on lateral disequilibrium and vestibular symmetry. The absence of anomaly in the fast dynamic test suggests that the type of scoliosis does not impair proprioception.

Stable intramedullary pinning is an excellent method for treating shaft fractures in children when there is an indication for operative management. It is a new biomechanical concept which aims at developing the bridging external callus. This closed pinning uses flexible rods which are introduced into a metaphysial area. Technique, results and indications are described particularly in regard to shaft fractures of the femur and the forearm. This closed surgical procedure can always be performed; complication rates are slight (no sepsis, no delayed union). Early mobilisation is possible, and use of a cast is unnecessary.

4.