{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:15:48Z","timestamp":1783664148607,"version":"3.55.0"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Paediatric femoral shaft fractures are one of the commonest injuries in early childhood and school-going children, with operative management increasingly preferred in the age group of 6\u201313 years. The titanium elastic nailing system (TENS) is the most preferred modality in this age group, providing stable fixation and biological preservation; however, its effect on mechanical axis alignment and early functional outcome needs evaluation. In this study, we aim to analyse the effect of femur shaft fractures being managed by TENS on the mechanical axis of the lower limb and its effect on the functional outcome of the patients after a short immobilisation period of 2 weeks.\n\nMaterials and Methods: A prospective observational study was conducted at Baba Raghav Das Medical College, Gorakhpur, between 2023 and 2025, including 32 children aged 6\u201313 years with femoral diaphyseal fracture undergoing TENS (excluding Gustillo-Anderson type IIIB\/IIIC injuries). Regular follow-up was done at 2, 6, and 12 weeks, and functional and radiological outcomes and mechanical alignment were recorded at 12 weeks using Flynn scoring criteria and an orthoscanogram, respectively.\n\nResults: Our study group had a mean age of 9.66 \u00b1 2.25 years, with a higher male predilection (71.9%) and road traffic accidents (43.8%) being the common mode of injury. We observed radiological union in all the patients with a mean union time of 10.88 \u00b1 0.9 weeks, with no significant malalignment with the mean medial proximal tibial angle and lateral distal femoral angle within an acceptable range, even after a short immobilisation period. We observed a mean knee flexion of 112.7\u00b0 \u00b1 13.7\u00b0 at the 12-week follow-up, with 81.2% of patients having an excellent outcome and the remaining 18.8% having a satisfactory outcome with no poor results.\n\nConclusion: TENS is a safe, minimally invasive, alignment-preserving modality which provides stable fixation and excellent short-term outcomes with minimal complications in the 6\u201313-year age group, irrespective of age, gender, or fracture type.\n\nKeywords: Paediatric femur shaft fracture, titanium elastic nailing system, elastic stable intramedullary nailing, mechanical axis alignment, functional outcome (Flynn criteria).<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i07.7702","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:34:30Z","timestamp":1783661670000},"page":"395-401","source":"Crossref","is-referenced-by-count":0,"title":["Early Mobilization with Mechanical Axis Preservation: A Prospective Outcome Analysis of Titanium Elastic Nailing in Femoral Shaft Fractures of School-Aged Children"],"prefix":"10.13107","volume":"16","author":[{"given":"Shivam","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atil K","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiut","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:34:32Z","timestamp":1783661672000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/07\/early-mobilization-with-mechanical-axis-preservation-a-prospective-outcome-analysis-of-titanium-elastic-nailing-in-femoral-shaft-fractures-of-school-aged-children-2\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i07.7702","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}