Outcome of Retrograde Titanium Elastic Nailing System in Shaft of Humerus Fractures: A Case Series

Humeral shaft fractures account for approximately 1-3% of all fractures and present a unique surgical challenge due to the proximity of the radial nerve. Retrograde titanium elastic nailing system (TENS) has gained increasing acceptance as a minimally invasive, load-sharing implant for managing such fractures, particularly in adolescents and young adults. This case series evaluates the functional and radiological outcomes of retrograde TENS in humeral shaft fractures.

We present a series of 10 patients (age range 19-55 years; M:F = 7:3) treated with retrograde TENS for humeral shaft fractures between (year) and (year). Fracture patterns included transverse (5), oblique (2), spiral (2), and comminuted (1) types at various levels of the humeral shaft. All patients underwent closed or minimally open reduction and retrograde elastic nailing under fluoroscopic guidance.

Mean time to clinical union was 13.8 weeks (range 10-20 weeks), and radiological union was confirmed in all patients. Functional outcomes assessed using the Constant-Murley shoulder score and Mayo Elbow performance score (MEPS) were excellent in 6 (60%) and good in 4 (40%) cases. Complications included one case of superficial wound infection, one of nail prominence at the elbow requiring removal, and one transient radial nerve neurapraxia that resolved completely at 8 weeks.

Retrograde TENS is a safe, effective, and minimally invasive option for humeral shaft fractures. It offers excellent fracture stabilization, early mobilization, and acceptable complication rates. It should be considered a viable alternative to conventional intramedullary nailing and plating, especially in younger patients.