摘要弹性髓内针(ESIN)技术在儿童长骨骨折的临床治疗中广泛应用.该技术突出优点为手术创伤小,而且不损伤儿童长骨的生长板.对ESIN固定技术的良好理解及对儿童骨折特殊病理生理特点的认识是取得ESIN良好治疗效果的先决条件.现讨论ESIN固定技术促进骨折愈合的生物力学特点,总结该技术在治疗儿童长骨骨折的原则、适应证和禁忌证,介绍目前ESIN技术在治疗儿童股骨、胫腓骨、肱骨、尺桡骨、锁骨及掌骨的临床应用,阐明ESIN技术的术前准备、髓内针大小的选择、进针位置、复位技巧及术后管理.

abstractsElastic stable intramedullary nailing (ESIN) is a well-accepted fixation method of long bone fractures in children.The advantages of ESIN include primary bone union with avoidance of growth plate injury and minimum invasive surgery.The good results of ESIN are obtained when surgeons have a good knowledge of the principle of the correction of the fracture and its stability, especially in the understanding of the unique pathophysiology characteristics of pediatric fractures.This review discussed the biomechanical mechanisms of ESIN, and the principles,indications and contraindications of ESIN in the treatment of pediatric long bone fractures.The article also comprehensively introduced the application of ESIN in femur,tibia,fibula,humerus, ulna, radius,clavicle and metacarpal bone fractures.The technique details of nailing, preoperative planning, positioning of the patient, sizing of the nail, entry points for the nail, reduction maneuvers for safe passage of nails through the fracture site, and postoperative management were also introduced in this review.