Titanium Elastic Nailing System in Adult Forearm Fractures: An Original Study

Punit  Tiwari; Tushaar Raj  Singh; Ankur  Salwan; Sandeep Singh  Jaura

doi:10.18502/jost.v12i1.21120

Punit Tiwari Professor, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
Tushaar Raj Singh Senior Resident, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
Ankur Salwan Assistant Professor, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
Sandeep Singh Jaura Assistant Professor, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India

DOI: https://doi.org/10.18502/jost.v12i1.21120

Keywords: TENS; Titanium; Fracture Fixation; Forearm; Radius; Ulna

Abstract

Background: The present study aimed to evaluate the early functional and radiological outcomes of forearm fractures in adultstreated using the titanium elastic nailing system (TENS).

Methods: This study was conducted between 2022 and 2025 in the department of orthopedics at a tertiary care medical college. Atotal of 30 adult patients with radiologically confirmed forearm fractures (radius, ulna, or both) treated with TENS nail wereincluded. Exclusion criteria comprised pathological or open fractures, prior forearm surgeries, and systemic conditions affectingbone health. Follow-ups were scheduled at one week for aseptic dressing and follow-up check X-ray, two weeks for stitches andbackslab removal, six weeks, and three months. Outcomes assessed included functional recovery using the Disabilities of the Arm,Shoulder, and Hand (DASH) and Grace-Eversmann scores, radiological union via the modified Radiographic Union Score for Tibiafractures (mRUST) scoring, and surgical complications.

Results: The mean age of patients was 47 years, with a predominance of ulna-only fractures (56.67%). Most patients were dischargedwithin three days post-surgery. Functional recovery improved significantly over time, with 73.33% achieving "excellent" Grace-Eversmann scores and 66.66% having DASH scores < 20 by 12 weeks (P = 0.002). Radiological healing progressed steadily, with allpatients achieving mRUST scores ≥ 11 at 12 weeks. The mean time t0 union was 11.6 weeks. Complications were minor and managedconservatively.

Conclusion: TENS in adult forearm fractures demonstrated excellent functional outcomes, fast radiological union, minimal surgicalmorbidity, and early return to activity. Given its minimally invasive nature and low complication rate, TENS represents a safe andeffective treatment modality for adult forearm fractures.