Fig. 3.

Transverse femoral shaft fracture in a 14-year-old boy. Elastic stable intramedullary nailing (ESIN) was performed at first without end caps. On the second post-operative day, the nails backed out and the telescoping into the fracture led to a 20° varus as well as a third fragment. This boy was reoperated on, and end caps were used to achieve complete consolidation without any malalignment or malrotation