TENS Nail Paediatric Radius and Ulna

Description

This video provides a comprehensive step-by-step guide on performing a TENS (Titanium Elastic Nailing System) nail procedure for the radius and ulna, specifically targeting pediatric diaphyseal fractures. The procedure begins with an overview of the patient, a 15-year-old boy with a displaced forearm fracture from a fall. The presenter emphasizes the importance of selecting the correct size of the nail, aiming to fill about 60% of the canal diameter for a single bone.



Several key techniques are discussed, such as positioning the patient and the operation table to enhance access and visibility, identifying the correct entry points for the nails, and discussing the pros and cons of using lateral versus dorsal entry points. Throughout the procedure, the significance of taking frequent X-rays is highlighted to ensure proper placement of the nails within the bone.



The presenter also provides tips for junior surgeons, outlining the steps for making incisions, carefully dissecting to avoid damaging surrounding tissues, and effectively negotiating the nail through the medullary cavity. The importance of maintaining a correct angle during insertion and using the bend of the nail to aid navigation through tight spaces is reiterated.



Towards the end of the operation, the presenter explains how to achieve proper reduction of the fracture and how to finish the procedure by cutting the nails to avoid irritation to the soft tissues. Finally, the video concludes with a recap of critical points for executing the procedure successfully and the reassurance that patients can start mobilizing the day following surgery.

Specialties