ESIN entry points in the pediatric femur for retrograde nailing
1. General considerations
For fracture patterns stabilized with the ESIN technique using a retrograde approach and two elastic nails, the entry points are at the same level in the distal femur on the lateral and medial side.
The entry points are 2–3 cm proximal to the growth plate, in the middle of the femoral shaft in the sagittal plane.
2. Skin incision
Make a 3 cm skin incision starting at the entry point and extending distally. This allows sufficient space to advance the nails at an angle to the cortex.
3. Deep dissection
Spread the fascia and muscle to expose the cortex of the femur.
4. Wound closure
After careful hemostasis, close the skin and subcutaneous tissues in a routine manner, preferably with resorbable sutures.
