Pathological or
spontaneous fractures in childhood are rare and are mostly caused by benign
bone diseases; the fractures must be treated on an individual basis, as there are no constant rules. Since the new method of osteosynthesis called "elastic stable
intramedullary nailing" (ESIN) or "embrochage centro-medullaire elastique stable" (ECMES) has demonstrated the best results in the treatment of normal fractures in childhood, this method is rapidly being used in the treatment of spontaneous or
pathological fractures. We report our experience in the treatment of
spontaneous fractures in childhood with "elastic stable
intramedullary nailing", in nine patients with ten fractures. The pathological diagnosis was in 5 cases a juvenile
bone cyst; in addition, there were cases of
histiocytosis X, lymphangiomatosis, hemangiomatosis and
osteoporosis (one each). The location was the femur (two cases) and humerus (seven cases). All fractures healed completely without
pseudarthrosis; as complications we saw one incidence of
osteomyelitis, one of a second fracture after "elastic stable
intramedullary nailing" and one
coxa vara in a child with
histiocytosis X of the proximal femur. In the 5 children with juvenile
bone cysts the nails are still in situ; in two cases the nails had to be changed.