Titanium elastic nail system in compound tibial fractures in children and adolescents

Background: Closed reduction and casting remain the gold standard treatment for tibial shaft fractures in children and adolescents. However, surgical intervention is indicated in cases of unstable fractures, open fractures, polytrauma, compartment syndrome, and fractures with severe soft tissue injury. The present study aimed to evaluate the safety and efficacy of Titanium Elastic Nailing System (TENS) in the management of compound tibial shaft fractures in children and adolescents. Methods: This retrospective study reviewed 18 cases of tibial shaft fractures treated with TENS from 2018 to 2021. Clinical outcomes were assessed based on fracture alignment, delayed union, non-union, infection, range of motion (ROM) of the knee and ankle, limb length discrepancy, and time to fracture union during follow-up visits. Outcomes were classified according to Flynn's criteria. Results: All patients achieved fracture union at a mean duration of 11.6 weeks, with full weight-bearing permitted at an average of 10 weeks. Limb shortening was observed in 4 patients. There were no cases of delayed union or non-union. At the final follow-up, 10 patients demonstrated excellent outcomes, while 8 had satisfactory outcomes. The most common complication was infection at the fracture site, observed in 6 patients. Conclusion: TENS is a safe, reliable, and effective treatment modality for compound tibial shaft fractures in children and adolescents. It facilitates rapid fracture healing with an acceptable complication rate.