Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 12 1 2026 03 06 23 8 EN Punit Tiwari Professor, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India Tushaar Raj Singh Senior Resident, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India Ankur Salwan Assistant Professor, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India Sandeep Singh Jaura Assistant Professor, Department of Orthopedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India 2025 07 16 2026 01 26 Background: The present study aimed to evaluate the early functional and radiological outcomes of forearm fractures in adults treated using the titanium elastic nailing system (TENS). Methods: This study was conducted between 2022 and 2025 in the department of orthopedics at a tertiary care medical college. A total of 30 adult patients with radiologically confirmed forearm fractures (radius, ulna, or both) treated with TENS nail were included. Exclusion criteria comprised pathological or open fractures, prior forearm surgeries, and systemic conditions affecting bone health. Follow-ups were scheduled at one week for aseptic dressing and follow-up check X-ray, two weeks for stitches and backslab removal, six weeks, and three months. Outcomes assessed included functional recovery using the Disabilities of the Arm, Shoulder, and Hand (DASH) and Grace-Eversmann scores, radiological union via the modified Radiographic Union Score for Tibia fractures (mRUST) scoring, and surgical complications. Results: The mean age of patients was 47 years, with a predominance of ulna-only fractures (56.67%). Most patients were discharged within three days post-surgery. Functional recovery improved significantly over time, with 73.33% achieving "excellent" Grace- Eversmann scores and 66.66% having DASH scores < 20 by 12 weeks (P = 0.002). Radiological healing progressed steadily, with all patients achieving mRUST scores ≥ 11 at 12 weeks. The mean time t0 union was 11.6 weeks. Complications were minor and managed conservatively. Conclusion: TENS in adult forearm fractures demonstrated excellent functional outcomes, fast radiological union, minimal surgical morbidity, and early return to activity. Given its minimally invasive nature and low complication rate, TENS represents a safe and effective treatment modality for adult forearm fractures. https://jost.tums.ac.ir/index.php/jost/article/view/691 https://jost.tums.ac.ir/index.php/jost/article/download/691/459