Clinical, radiological and functional outcomes of pediatric diaphyseal long-bone fractures treated with Titanium Elastic Nailing System: a prospective study

Background: Diaphyseal fractures of long bones represent a substantial proportion of paediatric skeletal injuries. The Titanium Elastic Nailing System (TENS) has emerged as a minimally invasive, biologically favourable method of internal fixation that facilitates early mobilization and fracture healing in children. The aim of the study is to assess the clinical, radiological, and functional outcomes of closed diaphyseal long-bone fractures in children aged 5–16 years treated surgically using TENS. Methods: A prospective interventional study was carried out between July 2020 and August 2022 at Government Medical College, Amravati, Maharashtra, India. Twenty-four children with 31 closed diaphyseal fractures of long bones underwent fixation using titanium elastic nails. Patients were followed at 3, 6, 12, and 24 weeks, and at 9 months postoperatively. Fracture union, alignment, complications, and functional outcomes were evaluated. Final outcomes were graded using Flynn’s scoring criteria (5). Results: The mean patient age was 12.20±2.58 years. The femur was the most frequently involved bone (37.5%), followed by both-bone forearm fractures (29.17%). The mean time to fracture union was 15.12±8.08 weeks, with 54.84% of fractures uniting by 12 weeks. Based on Flynn’s criteria (5), excellent outcomes were observed in 90.32% of fractures, satisfactory outcomes in 6.45%, and a poor outcome in 3.23%. Complications were minimal (9.68%), consisting mainly of entry-site irritation and one case of delayed union. No deep infections or implant failures were encountered. Conclusions: Titanium elastic nailing is a safe and effective treatment modality for paediatric diaphyseal long-bone fractures, providing reliable fracture stabilization, early union, favourable functional outcomes, and a low complication rate.