The titanium elastic nail serves as an alternative treatment for adult proximal radial shaft fractures: a cohort study

Abstract

BackgroundTo investigate whether closed reduction and internal fixation (CRIF) with titanium elastic nails (TENs) is a viable alternative treatment in proximal radial fractures.MethodsIn Kaohsiung Veterans General Hospital, from November 2013 to April 2015, five adult male patients with forearm injuries (average age 43 years; range 35–64 years) were treated for proximal radial shaft fractures. CRIF with TENs for radial shaft fractures was performed in these five patients. Radiographs; range of motions; visual analog scale (VAS); quick disabilities of the arm, shoulder, and hand (Quick DASH) questionnaire; and time to union were evaluated in our study.ResultsMean follow-up period was 30 months (range 28–36 months). Average time of radius union was 7.3 months (range 6–10 months). Functional outcomes 1 year after operation revealed an average Quick DASH score of 7.92 (range 4.5–25), an average VAS of 1.5 (range 1–3), and average forearm supination and pronation of 69.2° (range 45°–75°) and 82.5° (range 80°–85°). No major complication was noted.ConclusionsCRIF with TEN for adult proximal radial fractures is a method to avoid extensive exposure or nerve injury during ORIF, especially in multiple trauma patients who require short operative time, uremia patients with ipsilateral forearm AV shunt, severe soft tissue swelling due to direct muscle contusion or strong muscularity before surgery, extensive radial fracture, and those in pursuit of cosmetic outcomes.

Successful management of a distal clavicular fracture using Titanium elastic nail (TEN) fixation

“…The biomechanical principle underlying TEN involves the symmetrical bracing effect achieved by inserting these nails into the metaphysis [7] . Here, they exert pressure against the internal bone structure at 3 distinct points.…”

“…Here, they exert pressure against the internal bone structure at 3 distinct points. This technique provides immediate stability to the affected bone segment, enabling patients to mobilize early and resume their normal activities with a minimal risk of complications [7] . While TENs may not provide substantial axial and rotational stability, they offer relative stability conducive to secondary bone healing [7] .…”

An Evaluation of the Efficacy of Flexible Nailing in the Management of Diaphyseal Forearm Fractures: A Prospective Study in Rural India's Healthcare Settings

“…Lascombes and Metaizeau found 92% of their 80 patients had excellent results following intramedullary forearm nailing in both bones [14] Prakriti et al conducted a study among the adult Indian population and found 46.67% of their patients had good outcomes and 30% had excellent outcomes using the Grace and Eversman scoring system [22] . Ying-Cheng Huang et al, among the elder Taiwanese population, also concluded that TENS led to better outcomes using the Quick-Dash score, with a score of 7.92 (range 4.5-25, with lower scores indicating better outcomes) [23] .…”

Comparative study between hybrid fixation and dual plating in the management of both bone forearm fractures involving proximal half of radial shaft in adult patients

“…e stability gets further augmented when one of the two bones of the forearm is xed with plate osteosynthesis. e usual period of immobilization in such xation is up to four weeks and functional outcomes do not vary much with fracture displacement [10,18]. e application of TENs for xation of proximal radial sha fractures has been shown to have favorable functional outcomes in the past few studies [5,6,7] Although the union was delayed in 5 cases in the hybrid xation group, none of the patients developed non-union.…”

“…e fracture healing occurs on the principles of relative stability and additional protection to the fracture can be provided by a long-arm cast or splint. However, there is paucity in literature regarding the use of hybrid xation in adult both bone forearm fractures [10]. We a empted to explore the outcomes of hybrid xation with titanium elastic nail system (TENs) for radial sha fractures and standard plating ( compression or bridge mode ) for ulnar fractures in adult both bone forearm fractures involving proximal half of the radial sha and compared the radiological and functional outcomes with a control group that was treated with standard plating for both the fractures.…”