Clinical Outcomes and Current Evidence on Titanium Elastic Nailing in Pediatric Both-Bone Forearm Fractures: A Narrative Review

Both-bone forearm fractures are among the most common upper limb injuries in the pediatric population. Although many fractures can be managed conservatively, unstable or significantly displaced fractures often require surgical stabilization to restore anatomical alignment, maintain forearm rotation, and preserve future growth potential. Titanium elastic nailing has gained increasing popularity as a minimally invasive fixation technique that provides stable fracture stabilization while minimizing soft tissue disruption and physeal injury. This narrative review aims to evaluate the clinical effectiveness of titanium elastic nailing in pediatric both-bone forearm fractures. Despite widespread clinical adoption and favorable reported outcomes, variations remain regarding surgical indications, complication rates, and long-term functional results. Available literature was reviewed to assess fracture union rates, functional recovery, radiological outcomes, complication profiles, patient satisfaction, and comparative effectiveness with alternative treatment modalities. Existing studies consistently demonstrate reliable fracture healing, early mobilization, preservation of forearm range of motion, and favorable radiological alignment. Compared with plate fixation and external fixation, titanium elastic nailing is associated with reduced operative morbidity, shorter hospital stay, and improved cosmetic outcomes. Reported complications are generally minor and include nail prominence, local skin irritation, superficial infection, and the need for secondary implant removal. Titanium elastic nailing represents a safe and effective treatment option for appropriately selected pediatric both-bone forearm fractures. Optimal outcomes depend on appropriate patient selection, meticulous surgical technique, and careful postoperative monitoring. Although short- and mid-term outcomes remain encouraging, long-term outcome data are limited. Further well-designed studies are required to refine surgical indications, improve surgical techniques, and establish standardized treatment guidelines.