Journal of Musculoskeletal Trauma

Original Articles

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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Treatment of the Proximal Humeral Fractures: Se Il Suk, Sang Hoon Lee, In Joon Kim, Min Jong Park; J Korean Soc Fract 1989;2(1):1-8. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.1

Abstract PDF: Thirty-four patients with proximal humeral fratures were treated at department of orthopedic surgery, college of medicine, Seoul National University between 1978 and March, 19 99. They were followed up between six months and three and half years with average of 1.2 years. Mean age was 52.9 years and traffic accidents was the most common cause of injury. According to the Neers classification, there were seven one-part(20%), sixteen two-part(48%), seven three-part(20%) and four four-part(12%) fractures or fracture-dislocations. The methods of treatment and its results were analyzed according to the Neers classificatioin and they were summarized as follows; 1. Seven one-part fractures were treated conservatively and showed satisfactory results in all. 2. Sixteen two-part fractures were treated conservatively except tow old cases and showed satisfactory results except one. 3. Seven three-part fractures were tried to be reduced by closed means but unacceptable five cases were treated by open reduction. They showed satisfactory results except one. 4. Four four-part fractures were treated by open reduction in two, by prosthesis in headsplitting and severely comminuted cases. They showed satisfactory results except one.

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