RETROGRADE HUMERUS TENS NAILING – A COMPREHENSIVE CASE SERIES OF 15 PATIENTSLEARNING POINT OF THE ARTICLE

Abstract

Introduction
Humeral shaft fractures account for approximately 1–3% of all fractures and may be managed either conservatively or operatively. While plating and rigid intramedullary nailing remain standard surgical options, retrograde titanium elastic nailing (TENS) has emerged as a minimally invasive alternative that preserves fracture biology and facilitates early rehabilitation. This study presents a comprehensive case series evaluating radiological union, functional outcomes, and complications following retrograde TENS nailing for humeral shaft fractures.
Methods
Fifteen patients with acute, closed diaphyseal humeral fractures (AO/OTA 12A and 12B) were prospectively treated with retrograde TENS nailing between January 2023 and December 2024. Functional outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant–Murley score. Radiological union, complications, and time to union were recorded.
Results
All fractures achieved radiological union at a mean of 12.8 ± 1.6 weeks. The mean DASH score at final follow-up was X ± SD, and the mean Constant–Murley score was Y ± SD. Thirteen patients demonstrated excellent functional outcomes and two had good outcomes. Minor complications included nail prominence (2 cases), transient radial nerve neuropraxia (1 case), and delayed union (1 case), all of which resolved without long-term sequelae.
Conclusion
Retrograde TENS nailing is a safe and effective treatment option for selected humeral shaft fractures, offering predictable union, favorable functional outcomes, and minimal soft-tissue morbidity.