A minimally invasive orthopedic surgery known as the Titanium Elastic Nailing System (TENS) is mainly used to treat fractures in children. This technique uses flexible titanium nails placed into the medullary canal of long bones to provide internal stabilization and promote healing. TENS is widely recognized because of its ease of use, effectiveness, and capacity to enable patients to return to normal activities and mobilization at a younger age.
What is a Titanium Elastic Nailing System
The Titanium Elastic Nailing System comprises flexible nails made of titanium that are placed into the bone during the process of providing stability. Because titanium is elastic, it enables the best distribution of pressures along the length of the bone, promoting natural healing while minimizing problems. Because of the unique anatomical and physiological characteristics of pediatric patients, this technique is very useful in treating them.
Indications and Contraindications of Titanium Elastic Nailing System
Indications
- Fractures of the femur, tibia, humerus, and forearm happen in pediatric patients.
- Pathological fractures in kids.
- Select adult fractures where other fixing procedures fail.
- Fractures on the development plate require only a small amount of disruption.
- Minimum growth plate disruption fractures.
Warnings and precautions
- Extensive combination fractures are caused by elastic nails being insufficient for stability.
- When the size of the nails is not proper for the bone, it might be either small or huge.
- It is impossible to do intramedullary nailing in cases where open reduction is required.
- There is an active infection at the point of the fracture.
Planning Before the Operation
With the Titanium Elastic Nailing System, preoperative planning is required to achieve success. Among these are:
- X-rays or CT scans are used to perform a thorough analysis of the fracture, including its characteristics and location.
- It is important to choose the suitable nail size and length for the patient by consideration of their age, bone size, and fracture characteristics.
- The preparation of the required surgical instruments and the guarantee of the availability of image intensification for intraoperative guidance are also covered.
- Discuss the procedure, the outcomes that are anticipated, and the postoperative care requirements with the patient and their family.
Techniques Used in Surgery
The TENS surgical approach consists of several important phases, such as the below.
Anesthesia and Positioning
The patient is given general anesthesia, and the injured limb is positioned in a position that allows access to the fracture site.
Incision and Entry Point
The entry sites of the nails, which are normally located at the distal or proximal ends of the bone, are where small incisions are formed.
Insertion of Nails
The process of inserting nails involves the use of specialized devices to introduce flexible titanium nails into the medullary canal as part of the procedure. For the purpose of providing stability, the nails are advanced across the fracture site.
The fracture is reduced under imaging guidance, and the nails are adjusted to ensure that they are correctly positioned and fixed. Also included in this process is the reduction of the fracture.
Closure and Dressing
After the incisions have been closed, sterile dressings are applied to the wound locations.
Possible operation failures
- Problems with inserted materials causing allergies.
- Localized tumors on the bones.
- Osteoporosis or weak bones.
- System diseases and problems with metabolism.
- Using drugs and alcohol.
- Activities that put too much stress on the body include putting the implant through hits and/or strain.
- Patients who can’t understand or follow the doctor’s directions because of mental problems.
- Wellness issues.
Rehabilitation After Surgery
Rehabilitation and postoperative care are absolutely necessary for achieving the best possible recovery, which are listed below.
Immediate Postoperative Care
The management of pain, the monitoring for complications, and the guaranteeing of appropriate limb elevation and immobilization are all components of immediate postoperative care.
Early Mobilization
Encouraged as soon as possible in order to prevent stiffness and to facilitate healing. It is common practice to permit weight-bearing based on the kind of fracture and the stability of the fracture.
Physical Therapy
The goal of physical therapy is to restore the patient’s range of motion, strength, and function in a manner that is ideal for them. Regular follow-up appointments are planned in order to track the patient’s progress in healing and handle any concerns that may arise.
Recent Developments and Prospective Paths
The following are examples of recent developments in the titanium elastic nailing system:
Better Nail Designs
The creation of nails that have improved biomechanical properties in order to motivate faster healing and boost stability.
Improved Methods of Surgical Procedures
When it comes to nail insertion and fracture reduction, the use of computer-assisted navigation and imaging technology may significantly improve precision.
Biodegradable materials
Research into biodegradable materials that can provide temporary stability without the requirement for hardware removal will be needed for the development of biodegradable implants.
Increased Number of Indications
Examination of TENS use in different kinds of fractures and patient groups, besides pediatric cases.
The Risk of Adverse Reactions
Most of the time, implantation leads to the following bad effects.
- The TENS nail may become loose because of repeated stress on the anchoring site or a reaction in the tissue around the implant.
- Acute and chronic infections.
- More bone fractures are caused by unusual stress or bone substances that are already weak.
- Pressure or hematoma ta can cause temporary or permanent damage to the nerves.
- Wound hematomas take longer to heal.
- Vascular disease includes pulmonary embolism, venal thrombosis, and heart arrest.
- Heterotopic ossification.
- The Titanium Elastic Nail (TENS Nail) causes pain and discomfort.
- Breakage, bending, or loosening of the implant due to mechanical failure.
- Implant migration leads to harm.
Wrapping It Up
Pertaining to the treatment of fractures in children, the Titanium Elastic Nailing System is a technology that is both extremely effective and less intrusive. Because of its capacity to provide solid fixation while permitting early movement, it is a treatment of choice for an increasing number of orthopedic surgeons. A growing number of innovations in nail design and surgical techniques hold the promise of improving the outcomes and expanding the range of uses for this adaptable system. In order to get the most favorable results with TENS, it is important that you use careful patient selection, precision surgical technique, and complete postoperative care.
