TENS (Titanium Elastic Nail System) for Paediatric Femur Fracture

Description

This video content introduces a surgical demonstration of the TENS nailing procedure, specifically aimed at pediatric patients with femoral fractures. The presenter begins by explaining the TENS acronym, which stands for Titanium Elastic Nailing System, and emphasizes the importance of selecting the appropriate nail size based on the diameter of the bone's cortex.



The content discusses the marking of the medial and lateral cortices and provides calculations for determining the size of the nails needed to approximate 80% of the canal for long bone fractures, and 60% for single bone fractures.



Preparatory steps for the surgery are outlined, including patient preparation and identifying the precise insertion site, which is usually two centimeters proximal to the growth plate. The presenter highlights the technique for making the insertion hole at a 90-degree angle to the bone, advising on how to avoid complications during this critical step.



The video also covers the choice between pre-bending the nailing system or inserting it straight, noting that this can be a personal preference among surgeons. The presenter guides viewers through inserting the nail, emphasizing the importance of patience and technique to overcome resistance in the canal. They suggest a gentle tapping technique with a mallet to encourage proper placement.



As the demonstration progresses, the presenter discusses the process of adjusting the nail's direction to ensure its proper alignment with the proximal fragment of the bone. The commitment to using symmetrical nails and adjusting penetration depth is reiterated for optimal stability. The segment concludes with an efficient method of inserting the second nail after the first for enhanced stability during the operation.



Overall, the presentation balances technical surgical education with practical advice, offering insights into the intricacies of TENS nailing for pediatric femoral fractures.

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