Outcome of Radius and Ulna Shaft Fractures in Adults Treated by Titanium Elastic Nailing System
Keywords:
Radius shaft fracture; Ulna shaft fracture; Titanium Elastic Nailing System (TENS); Intramedullary nailing; Fracture union; Functional outcome.Abstract
Background: Adult diaphyseal fractures of the radius and ulna are functionally significant injuries that require anatomical reduction and stable fixation to restore forearm rotation and upper-limb function. Although plate osteosynthesis remains the conventional treatment, the Titanium Elastic Nailing System (TENS) has emerged as a minimally invasive alternative that preserves soft tissues and fracture biology while promoting satisfactory healing.
Aim: To evaluate the clinical outcome of adult radius and ulna shaft fractures treated with TENS by assessing postoperative forearm movements, fracture healing, functional recovery, and procedure-related complications.
Materials and Methods: This prospective observational study was conducted in the Department of Orthopaedics, G.K. General Hospital (GKGH), Bhuj, from September 2022 to March 2024. A total of 56 adult patients (18–70 years) with radius and ulna shaft fractures treated with TENS were included. Patients with pathological fractures, radio-ulnar joint instability, neurovascular injury at presentation, and polytrauma were excluded. Clinical and radiological evaluations were performed during follow-up to assess fracture union, range of forearm movements, complications, and final functional outcomes.
Results: The majority of patients were males (76.7%) and belonged to the 18–29-year age group (37.5%). Road traffic accidents were the leading cause of injury (50%), and 89.2% of fractures were closed. Fracture union occurred within 16 weeks in 62.49% of patients, while 82.14% regained full pronation and supination. Complications were infrequent, with nail back-out (5.35%) being the most common. Excellent functional outcomes were achieved in 92.85% of patients, with no unacceptable results.
Conclusion: TENS is a safe, effective, and minimally invasive method for treating selected adult diaphyseal fractures of the radius and ulna. It provides high union rates, excellent restoration of forearm function, minimal complications, and favorable overall clinical outcomes when performed with appropriate patient selection and surgical technique.
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