Elastic Intramedullary Nailing in Adult Radius and Ulna Fractures: A Modern Minimal Invasive Approach to Internal Fixation

Background: Forearm fractures in adults have traditionally been treated with open reduction and internal fixation (ORIF) using plates and screws. This study evaluates elastic intramedullary nailing (EIN) as a minimally invasive alternative for the treatment of adult radius and ulna fractures Methods: Forty adult patients (24 males, 16 females; mean age 36.7 years) with diaphyseal fractures of the radius and/or ulna were treated with elastic intramedullary nailing between January 2022 and December 2023. Patients were followed for a mean of 14.3 months. Outcomes were assessed using time to union, Disabilities of the Arm, Shoulder and Hand (DASH) score, Anderson criteria, range of motion, grip strength, and complications. Results: Union was achieved in 38 patients (95%) at a mean time of 11.8 weeks. Two patients (5%) developed delayed union, which eventually healed without intervention. At final follow-up, the mean DASH score was 8.4. According to Anderson criteria, excellent results were achieved in 32 patients (80%), satisfactory in 6 patients (15%), and unsatisfactory in 2 patients (5%). The mean range of motion showed near-complete restoration of function with elbow flexion-extension arc of 143.5°, wrist flexion-extension arc of 135.7°, and forearm rotation arc of 164.3°. Complications were observed in 8 patients (20%), including superficial infection (5%), hardware irritation (7.5%), and transient nerve paresthesia (5%). No cases of deep infection, implant failure, or nonunion were recorded. Conclusion: Elastic intramedullary nailing is a safe and effective minimally invasive treatment option for selected adult radius and ulna fractures, offering excellent union rates, favorable functional outcomes, and a low complication profile. This technique may be considered as an alternative to conventional plating in appropriate cases, particularly when minimizing soft tissue dissection is desirable.