The
Titanium Elastic Nail (TEN) offers a number of potential advantages over traditional ways of treating long
bone fractures particularly in the paediatric population. These advantages include earlier mobilisation and shorter
hospital stay and less risk of loss of fracture position. These advantages are most apparent and significant when treating
femoral fractures in children where the length of
hospital stay is reduced from several weeks to a typical period of 5 to 8 days. We have reviewed our early experience of using these implants over the past 2 years. Patients were assessed clinically and radiologically. 13 patients were treated using the TEN during this period. There were 2
femoral fractures, 4
humeral fractures, 1 tibial and 6 forearm fractures treated using the
Titanium Elastic Nail. All fractures united during the study period. However 1
humeral fracture required a secondary
bone grafting and plating for delayed union and 1 fracture lost position during follow-up. Insertion point
pain was a problem in 4 patients but this resolved after nail removal in all. There was 1 superficial
wound infection which resolved with
antibiotics and 1 superficial
wound infection of an
open fracture wound which resolved following nail removal and
antibiotics. There were no cases of deep
infection. There were no limb length discrepancy or rotational or angular malalignment problems. Biomechanical principles and technical aspects of this type of fixation are discussed.