Description
In this presentation, Megan Cashin discusses the optimal method for fixing forearm fractures in adolescents, focusing on the effectiveness of flexible intramedullary nailing compared to plate and screw fixation. Cashin introduces the topic by disclaiming any conflicts of interest and emphasizing the need for proper alignment and function in surgical treatment. She notes that while some fractures can be managed with traditional methods, flexible nailing presents several advantages, such as less invasive procedures that require minimal soft tissue dissection, shorter operating times, and high union rates.
The argument progresses as she addresses the common concerns associated with flexible nailing, including potential issues like delayed union and compartment syndrome, but counters these concerns by citing supporting literature and personal experience. Cashin also discusses the importance of patient-specific considerations and the evolving surgical landscape regarding pediatric fractures, highlighting a trend towards more aggressive surgical interventions for malunions.
Finally, she outlines the criteria for choosing the appropriate fixation method, advocating for flexible nailing for certain cases while acknowledging that plate fixation may still be preferable for older or more mature patients. Cashin concludes by emphasizing the effectiveness of flexible nailing in achieving good outcomes for adolescent patients while recognizing the need for further evidence-based research in this area.