Currently the gold standard in surgical treatment of displaced tibial shaft fractures in children with open growth cartilage is elastic stable intramedullary nailing (ESIN). The purpose of this study is the analysis of indications, complications, and duration of treatment using intramedullary flexible nails in children who are still growing but especially weighing 50 kg or more. Hospital records from 2017 to 2020 were retrospectively reviewed to identify the children from 4 to 17 years of age with displaced tibial shaft fractures admitted to the hospital. Only children with open growth cartilage, with a minimum of 6 months of follow-up and complete clinical data, were included. Studies of 91 children xwere analyzed. The average patient age at the time of the injury was 10.88 ± 2.82 years. In the entire group, 31.9% children weighed 50 kg or more, and 68.1% of the children were below this weight. All children were treated using ESIN. The mean time to nail removal was 8.4 ± 4.09 months in the whole group of children stabilized with ESIN. There were no differences in the two groups depending on the weight (P = 0.637). Only two adverse events were observed. This study demonstrates that the use of ESIN in displaced tibial shaft fractures in growing children weighing 50 kg or more is acceptable and safe. The discussion to be made is whether it is still an acceptable method of treatment for this type of fracture due to the progressive obesity epidemic in children and adolescents.

目前，手术治疗开放性生长软骨儿童移位胫骨干骨折的金标准是弹性稳定髓内钉（ESIN）。本研究的目的是分析仍在生长的儿童，尤其是体重 50 公斤或以上的儿童使用髓内柔性钉的适应症、并发症和治疗持续时间。回顾性分析2017年至2020年的医院记录，找出因移位性胫骨干骨折入院的4岁至17岁儿童。仅纳入具有开放性生长软骨、至少经过 6 个月随访且具有完整临床数据的儿童。对 91 名儿童的研究进行了分析。受伤时患者的平均年龄为 10.88 ± 2.82 岁。在整个群体中，31.9%的儿童体重在50公斤以上，68.1%的儿童低于此体重。所有儿童均接受 ESIN 治疗。在使用 ESIN 稳定的整组儿童中，拔除指甲的平均时间为 8.4 ± 4.09 个月。两组之间的体重差异没有差异（P = 0.637）。仅观察到两起不良事件。这项研究表明，对于体重 50 公斤或以上的成长儿童，使用 ESIN 治疗移位的胫骨干骨折是可以接受且安全的。需要讨论的是，由于儿童和青少年肥胖的流行，它是否仍然是治疗此类骨折的可接受的方法。