Functional and radiological outcomes of titanium elastic nailing in adult both-bone forearm fractures with proximal one-third radial shaft fractures: A prospective single-arm clinical study.

Dr Thakur Gaurav  Singh; Dr. Vaishali  Chhetri; Dr Shravan Kumar  Bharthala

doi:10.51168/sjhrafrica.v7i3.2532

Authors

Dr Thakur Gaurav Singh Assistant Professor, Department of Orthopaedics, Malla Reddy Institute of Medical Sciences, Sy No. 138, Suraram Main Road, GHMC Quthbullapur, Jeedimetla, Hyderabad, Telangana, India
Dr. Vaishali Chhetri Assistant Professor, Department of Orthopaedics, MediCiti Institute of Medical Sciences, Ghanpur, Medchal, Telangana, India
Dr Shravan Kumar Bharthala Senior Resident, Department of Orthopaedics, Government Medical College, Rajanna Sircilla District, Telangana, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2532

Keywords:

adult forearm fractures, both-bone forearm fracture, proximal radial shaft fracture, titanium elastic nailing, intramedullary fixation, functional outcome

Abstract

Background:

Adult diaphyseal fractures of both forearm bones require restoration of alignment, radial bow, and forearm rotation. Proximal one-third radial shaft fractures are technically demanding because open plating in this zone requires greater soft-tissue dissection and carries a risk of posterior interosseous nerve irritation.

Objectives:

To evaluate the functional and radiological outcomes of titanium elastic nailing in adult patients with both-bone forearm fractures associated with proximal one-third radial shaft fractures.

Methods:

This prospective single-arm study was conducted with 30 adult patients who underwent titanium elastic nailing. Patients were followed for at least one year. Forearm supination-pronation, pain by visual analog scale, radiological union, and return to work were assessed serially.

Results:

The cohort consisted predominantly of men [80.0%], and the most common age group was 31-40 years [36.7%]. Road traffic accident was the leading mechanism of injury [56.7%]. Closed reduction with titanium elastic nails was achieved in 29 patients, while one patient required limited open reduction for soft-tissue interposition. Fracture union was obtained in all 30 patients, with an average union time of 5 months. At final follow-up, all patients were pain-free, had painless near-maximum forearm rotation, and had returned to their previous work. No iatrogenic neurovascular or tendon injury, implant failure, delayed union, non-union, or secondary procedure was observed.

Conclusion:

Titanium elastic nailing provided stable fixation, reliable union, and excellent early functional recovery in this selected adult fracture pattern. It appears to be a useful minimally invasive option for proximal one-third radial shaft fractures associated with both-bone forearm injuries.

Recommendations:

Early TENS fixation with careful case selection, meticulous technique, and structured follow-up is recommended to achieve stable union and favorable function.

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