A 3-mm protrusion threshold after pediatric forearm ESIN: a rule-out safety margin, not a decision rule
Rui ZHANG, Sheng LU · 2026
Read A 3-mm protrusion threshold after pediatric forearm ESIN: a rule-out safety margin, not a decision rule by Rui ZHANG, Sheng LU (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/PMC13261750.txt.
Description
Rui Zhang and Sheng Lu write a 2026 letter on nail protrusion after elastic stable intramedullary nailing, a flexible-nail fixation for children's forearm fractures. The letter comments on a study by Brattgjerd and colleagues about keeping the implants in place instead of routine removal. The question is how far a nail may stick out before it irritates tissue.
The original data showed that when protrusion was under 3.3 mm, no implant was removed for irritation, a negative predictive value of 100%. A calculation put the upper 95% confidence limit for such removals at about 2.3%. Above the threshold, the positive predictive value was only 16%, so most protruding nails could still be retained. The letter warns against turning 3 mm into a rigid surgical target, since deeply seated nails are harder to remove later. It frames the threshold as a safety margin for ruling out risk, not a decision rule.
Catalog record
| CREATOR | Rui ZHANG, Sheng LU |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 4375 |
| LICENSE | https://creativecommons.org/licenses/by/4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |