{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T07:48:36Z","timestamp":1787212116061,"version":"build-2736575974"},"reference-count":24,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Forearm fractures in children are common. When conservative treatment fails, internal fixation with Elastic Stable Intramedullary Nailing (ESIN) become the first choice in the operative treatment of diaphyseal forearm shaft fractures. Refractures with the intramedullary nail in situ are known to occur but formal guidelines to guide management in such fractures are lacking.\u00a0We present a well-documented case of a radius midshaft refracture in a 12-year-old boy with the intramedullary nail in situ, managed by closed reduction. Literature is reviewed for this type of complication, the treatment of 30 similar cases is discussed and a treatment strategy is defined.<\/jats:p>\n               <jats:p>The refracture of the paediatric forearm fracture with the intramedullary nail in situ is a rare, but probably under recognised complication which is observed in approximately 2.3% of the study population. Closed reduction may be considered in these cases.<\/jats:p>","DOI":"10.1136\/bcr-2013-200840","type":"journal-article","created":{"date-parts":[[2013,9,25]],"date-time":"2013-09-25T06:36:30Z","timestamp":1380090990000},"page":"bcr2013200840","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Refractures of the paediatric forearm with the intramedullary nail in situ"],"prefix":"10.1136","volume":"2013","author":[{"given":"Pim W","family":"van Egmond","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, VU Medical Centre, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans A","family":"van der Sluijs","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, VU Medical Centre, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barend J","family":"van Royen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, VU Medical Centre, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachid","family":"Saouti","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, VU Medical Centre, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,9,24]]},"reference":[{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.1","first-page":"1463","article-title":"Managment of Fractures","volume-title":"Lovell and Winter's pediatric orthopaedics","volume":"2013","author":"Price","year":"2006"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.2","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/01.blo.0000156480.76450.04","article-title":"Pediatric fractures of the forearm","volume":"2013","author":"Rodriguez-Merchan","year":"2005","journal-title":"Clin Orthop Relat Res"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.3","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0020-1383(99)00151-5","article-title":"Refractures of the radius and ulna in children","volume":"2013","author":"Bould","year":"1999","journal-title":"Injury"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.4","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/00003086-197610000-00027","article-title":"Forearm fractures in children: pitfalls and complications","volume":"2013","author":"Davis","year":"1976","journal-title":"Clin Orthop Relat Res"},{"issue":"(Suppl 1)","key":"2025082805164974000_2013.sep24_1.bcr2013200840.5","doi-asserted-by":"crossref","first-page":"A25","DOI":"10.1016\/j.injury.2004.12.010","article-title":"State-of-the-art treatment of forearm shaft fractures","volume":"2013","author":"Schmittenbecher","year":"2005","journal-title":"Injury"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.6","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s11832-010-0245-y","article-title":"Failures and complications in intramedullary nailing of children's forearm fractures","volume":"2013","author":"Fernandez","year":"2010","journal-title":"J Child Orthop"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.7","first-page":"420","article-title":"Flexible intramedullary nailing of pediatric unstable forearm fractures","volume":"2013","author":"Kanellopoulos","year":"2005","journal-title":"Am J Orthop"},{"issue":"(Suppl 1)","key":"2025082805164974000_2013.sep24_1.bcr2013200840.8","doi-asserted-by":"crossref","first-page":"A20","DOI":"10.1016\/j.injury.2004.12.009","article-title":"The principles of elastic stable intramedullary nailing in children","volume":"2013","author":"Hunter","year":"2005","journal-title":"Injury"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.9","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1302\/0301-620X.60B2.350882","article-title":"The biology of fracture healing in long bones","volume":"2013","author":"McKibbin","year":"1978","journal-title":"J Bone Joint Surg Br"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.10","unstructured":"Metaizeau JP . Osteosynthese chez l'enfant par Embrochage Centro-Medullaire elastique stable. Monpellier: Sauramps Medical, 1988."},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.11","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1097\/01.bpo.0000235397.64783.d6","article-title":"Use and abuse of flexible intramedullary nailing in children and adolescents","volume":"2013","author":"Lascombes","year":"2006","journal-title":"J Pediatr Orthop"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.12","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00068-005-1071-7","article-title":"ESIN in forearm fractures","volume":"2013","author":"Lieber","year":"2005","journal-title":"Eur J Trauma"},{"key":"2025082805164974000_2013.sep24_1.bcr2013200840.13","first-page":"88","article-title":"Intramedullary nailing of forearm fractures in children","volume":"2013","author":"Griffet","year":"1999","journal-title":"J Pediatr Orthop 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