Retrograde Titanium Elastic Nailing for Diaphyseal Fractures of the Humerus in Children through a Single Central Entry Point: A Case Series with Review of Literature.

INTRODUCTION: Almost all paediatric humerus fractures can be managed conservatively with a high rate of union. Surgical intervention may be indicated in a few scenarios. Retrograde nailing with titanium elastic nails through a central entry point proximal to the olecranon fossa offers several advantages when surgical fixation is indicated.

CASE REPORT: Three male patients in the age group of 5-14 years with diaphyseal left humerus fractures were treated with retrograde elastic nailing after failed conservative management. The mean age of the patients was 10 years. All the surgeries were performed under general anaesthesia. The mean operative time was 100 minutes. The mean union time was 12 weeks. The mean follow-up duration was 26.3 months. One patient developed a superficial surgical site infection, and the nails had to be removed 9 weeks after the surgery. The QuickDASH score of all the patients 3 months after surgery was zero, indicating no disability. All patients had excellent outcomes.

CONCLUSION: When surgical stabilization of paediatric humeral shaft fractures is indicated, retrograde elastic nail fixation with two nails through a central entry point is a reliable technique, with a low risk of complications, offering stable fixation that eliminates the need for uncomfortable immobilization and enables early mobilization of the arm.