Clinical Outcome of Surgical Management of Diaphyseal Forearm Fracture of Children Using Titanium Elastic Nail

Abstract

Introduction: Diaphyseal forearm fractures are among the most common fractures in the pediatric population. While conservative management with closed reduction and casting remains standard for most cases, unstable fractures, open fractures, or fractures failing conservative treatment often require surgical intervention. Titanium elastic nailing (ten) has emerged as a minimally invasive and effective method for internal fixation, offering advantages of early mobilization, excellent alignment, and rapid functional recovery. Methods: This institutional-based, prospective observational study was conducted at the department of orthopaedics, burdwan medical college & hospital, over a period of 18 months from may 2020 to october 2021. The study included 10 pediatric patients presenting to the outpatient department and emergency with diaphyseal forearm fractures, all of whom were treated with titanium elastic nailing. Written informed consent was obtained from all participants after explaining the study details. The study variables included age, sex, injury-to-surgery interval, postoperative complications, range of movement, and overall functional outcome. All patients were followed up to assess radiological union, range of motion, complications, and functional recovery. Results: In this study of 10 pediatric patients, the majority (80%) were aged 9–12 years, with a male predominance (80%). Surgery was performed within 14 days for most patients (90%), and radiological union was achieved within 10 weeks in 70% of cases. Postoperative complications were minimal, with only 3 patients experiencing issues such as granulation tissue, nail protrusion, or bending. Functional recovery was generally excellent, with 60% achieving full flexion and extension, and 70% attaining full supination and pronation, while minor restrictions were observed in a few patients. Overall, functional outcomes were excellent in 70% and good in 30% of patients, with no fair or poor results, indicating favorable recovery following surgical management. Conclusion: Titanium elastic nailing provides a safe and effective method for the surgical management of diaphyseal forearm fractures in children. It ensures stable fixation, allows early mobilization, and achieves excellent functional and radiological outcomes with minimal complications. Ten should be considered the preferred surgical option for pediatric forearm fractures unsuitable for conservative treatment.