Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2019; 10(8): 299-303
Published online Aug 18, 2019. doi: 10.5312/wjo.v10.i8.299
Rigid locked nail fixation for pediatric tibia fractures - Where are the data?
Daniel Weltsch, Keith D Baldwin
Daniel Weltsch, Keith D Baldwin, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, United States
Daniel Weltsch, Department of Orthopaedic Surgery, The Chaim Sheba Medical Center at Tel Hashomer, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan 52620, Israel
Keith D Baldwin, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States
Author contributions: Weltsch D and Baldwin KD contributed to data collection, statistical analysis, development of manuscript structure, initial manuscript drafting, and final manuscript editing.
Conflict-of-interest statement: The authors declare personal fees from JBJS reviews, personal fees from Synthes, other from Pfizer, Inc., and other from Simple Therapy, outside the submitted work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Keith D Baldwin, MD, MPH, MSPT, Assistant Professor, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States. baldwink@email.chop.edu
Telephone: +1-215-5901527 Fax: +1-215-5901501
Received: March 12, 2019
Peer-review started: March 15, 2019
First decision: June 12, 2019
Revised: June 27, 2019
Accepted: July 23, 2019
Article in press: July 23, 2019
Published online: August 18, 2019
Core Tip

Core tip: Little data exists to support the use of reamed intramedullary nails (RIMN) in adolescents and skeletally immature pre-adolescents. However, RIMN is used as the cornerstone of fixation for skeletally mature patients and older skeletally immature patients. Although we are not aware of any papers or case reports of RIMN use which resulted in growth arrest or recurvatum deformity in the pediatric population, surgeons are reluctant to use this nail design in younger patients. Clinical data regarding RIMN and a reliable and easy to apply skeletal maturity measure for the proximal tibia are needed for better decision making in such cases.