Clinical efficacy of titanium elastic nail fixation for the treatment of pediatric limb fractures and its impact on postoperative bone mineral density and bone metabolism levels

OBJECTIVE: This study was designed to examine the clinical efficacy of titanium elastic nail (TEN) fixation in treating pediatric long bone fractures of the limbs and its impact on bone mineral density (BMD) and bone metabolism. METHODS: Sixty children with long bone fractures of the limbs were divided into the control group (underwent open reduction and internal fixation with a plate) and the observation group (received TEN fixation) (n = 30 each group). Surgical indicators (operative time, intraoperative blood loss, fracture healing time, and hospital stay), fracture healing excellence rate, complication incidence, and overall clinical effectiveness were compared. BMD, serum basic fibroblast growth factor (bFGF), total type I collagen N-terminal propeptide (TPINP) levels, the Hospital for Special Surgery (HSS) knee function score, Harris hip function score, and Mayo Elbow Performance Score (MEPS) were assessed. RESULTS: The observation group exhibited superior surgical indicators, higher fracture healing excellence rate, overall clinical effectiveness, and lower complication incidence than controls (all p < 0.05). At 3 months postoperatively, BMD and bFGF had increased, and TPINP had decreased compared to preoperative values in both cohorts, with the observation group showing higher/lower measures (all p < 0.05). At 6 months postoperatively, the observation group achieved higher HSS, Harris, and MEPS scores compared with the control group (all p < 0.05). CONCLUSION: TEN fixation accelerates fracture healing, reduces complications, improves BMD and bone metabolism, and restores joint function in children with long bone fractures of the limbs.