Description
This presentation by Pranai Buddhdev focuses on the principles and techniques of nailing for pediatric fractures, particularly diaphyseal fractures in skeletally immature patients. It begins with an overview of the significance of flexible and rigid nailing methods, emphasizing their historical context and biomechanical foundations. The talk outlines the technique of flexible nailing, which has been in practice for over five decades, highlighting its minimally invasive nature and the preservation of endosteal circulation that encourages rapid healing. Key points discussed include the anatomy of nails used, principles of insertion, fixation techniques, and the importance of nail contouring to suit different patient sizes.
Pranai discusses how to choose the appropriate size of nails and the goal of maximizing fixation in the femur and tibia to achieve effective results. He also addresses potential complications, like malalignment and the need for blood supply preservation if rigid nails are used. Case studies illustrate varying fracture presentations and the surgical approaches taken, demonstrating outcomes similar to those seen in adults with transverse fractures.
Pranai emphasizes the importance of correctly positioning and reducing fractures to avoid future mobility issues, especially concerning foot rotation. He compares tibial nailing and humeral nailing, pointing out the challenges of nailing triangular-shape tibial bones compared to more cylindrical humeral bones. He wraps up the presentation by discussing the importance of managing complications and maintaining optimal rehabilitation post-surgery.