{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:41:55Z","timestamp":1792402915048,"version":"4.4.0"},"reference-count":29,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Objective: This study was designed to examine the clinical efficacy of titanium elastic nail (TEN) fixation in treating pediatric long bone fractures of the limbs and its impact on bone mineral density (BMD) and bone metabolism.\nMethods: Sixty children with long bone fractures of the limbs were divided into the control group (underwent open reduction and internal fixation with a plate) and the observation group (received TEN fixation) (n = 30 each group). Surgical indicators (operative time, intraoperative blood loss, fracture healing time, and hospital stay), fracture healing excellence rate, complication incidence, and overall clinical effectiveness were compared. BMD, serum basic fibroblast growth factor (bFGF), total type I collagen N-terminal propeptide (TPINP) levels, the Hospital for Special Surgery (HSS) knee function score, Harris hip function score, and Mayo Elbow Performance Score (MEPS) were assessed.\nResults: The observation group exhibited superior surgical indicators, higher fracture healing excellence rate, overall clinical effectiveness, and lower complication incidence than controls (all p &lt; 0.05). At 3 months postoperatively, BMD and bFGF had increased, and TPINP had decreased compared to preoperative values in both cohorts, with the observation group showing higher\/lower measures (all p &lt; 0.05). At 6 months postoperatively, the observation group achieved higher HSS, Harris, and MEPS scores compared with the control group (all p &lt; 0.05).\nConclusion: TEN fixation accelerates fracture healing, reduces complications, improves BMD and bone metabolism, and restores joint function in children with long bone fractures of the limbs.<\/jats:p>","DOI":"10.2340\/jphs.v61.46896","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:08:33Z","timestamp":1792400913000},"page":"257-262","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy of titanium elastic nail fixation for the treatment of pediatric limb fractures and its impact on postoperative bone mineral density and bone metabolism levels"],"prefix":"10.2340","volume":"61","author":[{"given":"Zhanhui","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donger","family":"Hai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoliang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"171408","doi-asserted-by":"crossref","unstructured":"David AL, Mucsina F, Antal E, et al. Comparison of titanium versus resorbable intramedullary nailing in pediatric forearm fractures. Children (Basel). 2024;11(8):942.","DOI":"10.3390\/children11080942"},{"key":"171409","doi-asserted-by":"crossref","unstructured":"Garcia-Rueda MF, Mendoza-Pulido C, Taborda-Aitken JC, et al. Distribution of fractured bones among children: experience with the comprehensive pediatric AO classification in a children\u2019s orthopedic hospital in Bogota-Colombia. Injury. 2023;54(Suppl. 6):110780.","DOI":"10.1016\/j.injury.2023.05.011"},{"key":"171410","doi-asserted-by":"crossref","unstructured":"Grothaus O, Monson H, Brennan J, et al. Pediatric both bone forearm fractures: re-evaluating unacceptable alignment and remodeling potential in children up to 11 years old. J Pediatr Soc North Am. 2026;14:100305.","DOI":"10.1016\/j.jposna.2025.100305"},{"key":"171411","doi-asserted-by":"crossref","unstructured":"Li FH, Dong B, Li CJ, et al. Pediatric fractures in northern China: hospital-based epidemiology and high-risk factors from a regional cohort study. Front Pediatr. 2026;14:1678240.","DOI":"10.3389\/fped.2026.1678240"},{"key":"171412","unstructured":"Sanjay P, Diwakar R, Singh S, et al. A review of pediatric orthopedic disorders: diagnosis and treatment updates. Cureus. 2026;18(1):e101486."},{"key":"171413","doi-asserted-by":"crossref","unstructured":"Kamaci S, Yilmaz ET, Goker B, et al. Epidemiology of pediatric fractures and effect of socioeconomic status on fracture incidence in Turkiye: a nationwide analysis of 2 million fractures. J Pediatr Orthop. 2025;45(4):e331\u2013e337.","DOI":"10.1097\/BPO.0000000000002881"},{"key":"171414","doi-asserted-by":"crossref","unstructured":"Liu W, Li W, Bai R, et al. Elastic stable intramedullary nailing versus plate internal fixation for pediatric diaphyseal femur fractures: a systematic review and meta-analysis. Indian J Orthop. 2024;58(5):484\u2013494.","DOI":"10.1007\/s43465-024-01125-3"},{"key":"171415","doi-asserted-by":"crossref","unstructured":"Kalbitz M, Fischer A, Weber B, et al. Diaphyseal femur fractures in children and adolescents-opportunities and limitations of the ESIN technique. J Clin Med. 2022;11(24):7345.","DOI":"10.3390\/jcm11247345"},{"key":"171416","doi-asserted-by":"crossref","unstructured":"Reddy E, Sriwastwa A, Patel S, et al. Elastic stable intramedullary nailing for pediatric forearm fractures: a review article. J Clin Orthop Trauma. 2025;71:103249.","DOI":"10.1016\/j.jcot.2025.103249"},{"key":"171417","doi-asserted-by":"crossref","unstructured":"Pogorelic Z, Vegan V, Jukic M, et al. Elastic stable intramedullary nailing for treatment of pediatric tibial fractures: a 20-year single center experience of 132 cases. Children (Basel). 2022;9(6):845.","DOI":"10.3390\/children9060845"},{"key":"171418","doi-asserted-by":"crossref","unstructured":"Landau AJ, Oladeji AK, Cummings JL, et al. Outcomes of elastic stable intramedullary nailing for surgical treatment of pediatric tibial shaft fractures. J Am Acad Orthop Surg Glob Res Rev. 2023;7(12):e23.00031.","DOI":"10.5435\/JAAOSGlobal-D-23-00031"},{"key":"171419","doi-asserted-by":"crossref","unstructured":"Wang Y, Hu H, Huang Y. Advances in the application of bone turnover markers for pediatric growth and developmental disorders: a review. Front Endocrinol (Lausanne). 2025;16:1615712.","DOI":"10.3389\/fendo.2025.1615712"},{"key":"171420","doi-asserted-by":"crossref","unstructured":"Hu D, Xu Z, Shi T, et al. Elastic stable intramedullary nail fixation versus submuscular plate fixation of pediatric femur shaft fractures in school age patients: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2023;102(39):e35287.","DOI":"10.1097\/MD.0000000000035287"},{"key":"171421","doi-asserted-by":"crossref","unstructured":"Zhou X, Chen J, Sun H, et al. Spatiotemporal regulation of angiogenesis\/osteogenesis emulating natural bone healing cascade for vascularized bone formation. J Nanobiotechnol. 2021;19(1):420.","DOI":"10.1186\/s12951-021-01173-z"},{"key":"171422","doi-asserted-by":"crossref","unstructured":"Korpysz A, Jaworski M, Skorupa E, et al. Bone turnover markers during growth hormone therapy for short stature children born small for gestational age. Biomedicines. 2024;12(8):1919.","DOI":"10.3390\/biomedicines12081919"},{"key":"171423","doi-asserted-by":"crossref","unstructured":"Kong JS, Huang Y, Chen T, et al. Comparison of open reduction and internal fixation with plate and titanium elastic intramedullary nail in treating pediatric humeral fracture. Orthop Surg. 2021;13(2):434\u2013441.","DOI":"10.1111\/os.12897"},{"key":"171424","doi-asserted-by":"crossref","unstructured":"Li J, Wu J, Zhang Y, et al. Elastic stable intramedullary nailing for pediatric humeral shaft fractures under ultrasonographic guidance: a retrospective study. Front Pediatr. 2021;9:806100.","DOI":"10.3389\/fped.2021.806100"},{"key":"171425","doi-asserted-by":"crossref","unstructured":"Gonder N, Karabulut C, Bilgin MA, et al. Clinical and radiographic outcomes of ESIN, plate, and K-wire fixation in pediatric tibial DDMJ fractures: a retrospective comparative study. Children (Basel). 2025;12(10):1345.","DOI":"10.3390\/children12101345"},{"key":"171426","doi-asserted-by":"crossref","unstructured":"Dong L, Wang Y, Jiao Q, et al. Clinical efficacy of minimally invasive elastic stable intramedullary nailing for limb long bone fractures in children. Orthop Surg. 2021;13(4):1336\u20131342.","DOI":"10.1111\/os.12977"},{"key":"171427","doi-asserted-by":"crossref","unstructured":"Kim WS, Oh MJ, Park MS, et al. Comparison of surgical outcomes between bioabsorbable and metal screw fixation for distal tibial physeal fracture in children and adolescent. Int Orthop. 2024;48(10):2681\u20132687.","DOI":"10.1007\/s00264-024-06284-4"},{"key":"171428","doi-asserted-by":"crossref","unstructured":"Sun LJ, Yang J, Tian NF, et al. Pediatric femoral shaft fractures treated with titanium elastic nailing. Orthopedics. 2014;37(11):e1021\u2013e1026.","DOI":"10.3928\/01477447-20141023-60"},{"key":"171429","doi-asserted-by":"crossref","unstructured":"Zhang Y, Xue Y, Zhao M, et al. Titanium elastic nails vs locking plate in pediatric subtrochanteric femur fractures: a systematic review and meta-analysis. Front Pediatr. 2023;11:1114265.","DOI":"10.3389\/fped.2023.1114265"},{"key":"171430","doi-asserted-by":"crossref","unstructured":"Tang X, Liang J, Zhang B, et al. An alternative choice for overweight pediatric patient with femoral shaft fracture when rigid nail is contraindicated due to narrow intramedullary canal: elastic stable intramedullary nail plus temporary external fixator. J Orthop Sci. 2025;30(5):941\u2013945.","DOI":"10.1016\/j.jos.2025.01.002"},{"key":"171431","doi-asserted-by":"crossref","unstructured":"Aditya KS, Singh V, Regmi A, et al. Elastic stable intramedullary nailing versus submuscular plating in length unstable pediatric diaphyseal femur fractures: a prospective comparative study. J Clin Orthop Trauma. 2025;63:102920.","DOI":"10.1016\/j.jcot.2025.102920"},{"key":"171432","doi-asserted-by":"crossref","unstructured":"Li Y, Helvie P, Farley FA, et al. Complications after plate fixatio n of displaced pediatric midshaft clavicle fractures. J Pediatr Orthop. 2018;38(7):350\u2013353.","DOI":"10.1097\/BPO.0000000000000832"},{"key":"171433","doi-asserted-by":"crossref","unstructured":"Mussell EA, Jardaly A, Gilbert SR. Length unstable femoral fractures: a misnomer? World J Orthop. 2020;11(9):380\u2013390.","DOI":"10.5312\/wjo.v11.i9.380"},{"key":"171434","doi-asserted-by":"crossref","unstructured":"Cooper BJ, Wendling AC, Isaacs-Pullins SR, et al. Stacked 1\/3 tubular plates for fixation of pediatric forearm fractures: a biomechanical study. Kans J Med. 2022;15(1):63\u201366.","DOI":"10.17161\/kjm.vol15.16207"},{"key":"171435","doi-asserted-by":"crossref","unstructured":"Chen YP, Lin CH, Hong CK, et al. Plate versus screw fixation in treating pediatric femoral neck fractures: a systematic review. J Pediatr Orthop. 2026;46(5):e402\u2013e411.","DOI":"10.1097\/BPO.0000000000003207"},{"key":"171436","doi-asserted-by":"crossref","unstructured":"Cicekli O, Ozdemir G, Uysal M, et al. 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Springerplus. 2016;5(1):1925.","DOI":"10.1186\/s40064-016-3623-1"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/46896\/55892","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/46896\/55892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:08:40Z","timestamp":1792400920000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/46896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":29,"URL":"https:\/\/doi.org\/10.2340\/jphs.v61.46896","relation":{},"ISSN":["2000-6764"],"issn-type":[{"value":"2000-6764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]}}}