Arnold Besselaar, Daniel Green, Andrew Howard
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.
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.
Spread the fascia and muscle to expose the cortex of the femur.
After careful hemostasis, close the skin and subcutaneous tissues in a routine manner, preferably with resorbable sutures.