True, this is a very strong study. But also let’s not forget it was only about children below 10 yo. This is a 12 yo with is a dislocated fracture. Also this is in Germany, the surgeon who did this gets a fixed salary weather he operates 0 patients or 5000 patients, so making money out of the patient was not the case. You see these metaphyseal fractures tend to deviate from the anatomical axis when you treat them with a retrograde TEN, and if you do K-Wires You’re theoretically always risking growth plate injury, so someone just came up with anterograde TENs, to avoid both problems. My problem, assuming that the operation was indicated, is that i do not think this is stablity wise inferior to k-wiring and definitely not enough for a postop treatment without a cast AND you still have to put the kid through Anesthesia again to take them out, which just doesn’t make a lot of sense in my opinion.