Journal of Musculoskeletal Trauma

Original Article

Clinical and radiographic outcomes of elastic stable intramedullary nailing for pediatric humeral shaft fractures: a retrospective case series: Kang-San Lee, Dongju Shin, Sang Hee Kim, Il Seo, Tae-Hoon Kim, Sung Jung Kim; Received December 4, 2025 Accepted January 23, 2026 Published online March 10, 2026; DOI: https://doi.org/10.12671/jmt.2025.00381 [Epub ahead of print]

Abstract PDF: Background
Pediatric humeral shaft fractures are uncommon and are generally treated conservatively, with satisfactory clinical outcomes reported in most cases. However, conservative management often necessitates prolonged immobilization and frequent outpatient follow-up visits, and it carries an inherent risk of residual angular or translational deformity. Elastic stable intramedullary nailing (ESIN) provides a simple and minimally invasive method of fracture fixation that offers adequate stability without disrupting the periosteal blood supply, thereby permitting early mobilization and promoting rapid bone union. The purpose of this study was to evaluate the clinical and radiological outcomes of ESIN fixation in pediatric patients with humeral shaft fractures.
Methods
The medical records of pediatric patients with humeral shaft fractures who underwent ESIN fixation between January 2015 and November 2025 were retrospectively reviewed. Data collected included patient demographics, mechanism of injury, fracture location, number of elastic nails used, time to union, degree of residual angulation, range of motion (ROM), and postoperative complications.
Results
The mean age of the patients was 10.0 years (range, 7 to 15 years). The mean time to radiographic union was 5.4 weeks (range, 2.4 to 10.4 weeks). The mean coronal angulation was 0.2° (range, −9.1° to 5.8°), while the mean sagittal angulation was −1.3° (range, −6.9° to 5.3°). No cases of infection, nerve injury, or nail migration were observed during the follow-up period. At the final follow-up assessment, all patients demonstrated full shoulder and elbow ROM, with no residual deformity or pain reported.
Conclusions
In this small retrospective case series, ESIN fixation resulted in favorable union rates and excellent functional outcomes in pediatric humeral shaft fractures. Level of evidence: Level IV.

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