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Functional and Radiological Outcomes of Pediatric Both-Bone Forearm Fractures Treated with Titanium Elastic Nailing
A Karthick1, M Dharun Kumar1, Ashin Khan1
1Department of Orthopedics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
Background:
Diaphyseal fractures of the radius and ulna are among the most frequent long-bone injuries in children. While conservative management is often effective in stable fractures, surgical fixation is preferred for unstable or displaced fractures. The Titanium Elastic Nailing System (TENS) offers a minimally invasive fixation technique that preserves periosteal circulation and promotes early mobilization. This study aimed to evaluate the functional and radiological outcomes of pediatric both-bone forearm fractures treated with TENS.
Methods:
A prospective observational study was conducted among 20 children (aged 4-12 years) with diaphyseal fractures of both radius and ulna treated using TENS at a tertiary hospital between January 2024 and June 2025. Functional outcomes were assessed using the Children's Hospital of Philadelphia criteria and Price et al. grading system. Radiological union was defined by bridging callus formation in at least three cortices on orthogonal radiographs.
Results:
The mean age was 8.6 years, and 65% were males. The mean time to radiological union was 8.36 weeks (range: 6-14 weeks). Based on Price criteria, 75% of patients achieved excellent, 20% good, and 5% fair functional outcomes. Minor complications included pin-site infection (15%) and entry-site irritation (5%), with no nonunion or neurovascular injury.
Conclusion:
TENS provides stable fixation, early union, and excellent functional recovery in pediatric both-bone forearm fractures. Its minimally invasive nature and low complication profile make it a preferred treatment modality for unstable diaphyseal fractures in children.
