Functional Outcome of Titanium Elastic Nailing System in Patients with Minimally Displaced Proximal Humerus Fractures
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Abstract
Background: Minimally displaced proximal humerus fractures, particularly Neer type 2 involving the surgical neck, are common in the elderly. Conservative management risks stiffness, while traditional fixation methods have limitations. This study evaluates the functional outcomes and complications of Titanium Elastic Nailing System (TENS) in adults with these fractures. Methods: Prospective study of 51 patients (>18 years) with minimally displaced proximal humerus fractures treated with closed reduction and retrograde TENS (some with additional cannulated cancellous screws for greater tuberosity avulsion) at a single institution (April 2024-April 2025). Functional outcomes assessed using Constant-Murley score at follow-up; union assessed radiographically. Results: Mean age 68 years; 58.8% female; 70% Neer grade 2. Union achieved in most by 6-8 weeks (41.2% at 8 weeks). Functional outcomes: excellent 11.8%, good 33.3%, fair 54.9%. Complications in 27.5% (mainly nail migration 21.6%; pin-site infection 5.9%). Significant association between Neer grade and outcome (p=0.04); no significant association with age (p=0.479) or gender (p=0.348). Conclusion: TENS provides stable, minimally invasive fixation with favorable union times and mostly good-to-fair functional recovery in minimally displaced proximal humerus fractures, especially Neer grade 2. Nail migration warrants careful technique and monitoring. TENS merits consideration for early mobilization in suitable cases.
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Copyright (c) 2026 Dr. Sandeep MMR, Dr. Hari Prasath P., Dr. Ezhil Vikarama Vell G., Dr. Yee Tun Oo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
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