Description
In this talk, Paul Jenkins, a surgeon from a deprived area, engages in a nuanced discussion about the management of distal humerus fractures. He emphasizes the importance of careful decision-making in choosing between fixation and replacement based on the socio-demographic context and the individual patient. Jenkins challenges the oversimplified notion of categorizing fractures as merely fixable or unfixable, arguing that this approach overlooks the complexities and unique circumstances surrounding each case.
He highlights the dual roles of clinicians as both advocates and decision-makers in the absence of clear evidence-based medicine to guide them. Drawing on his own experiences and training, he navigates through the historical evolution of elbow replacement techniques, the significance of contemporary arthroplasty options, and the varied results from data in countries like Sweden. Jenkins discusses the critical balance of probabilities that guides clinical decisions, suggesting a strategic approach to both fixation and arthroplasty, particularly in elderly patients.
Furthermore, he addresses specific technical challenges in fixation, such as screw and plate placement, and reiterates the importance of minimizing complications during surgical procedures. Questions about patient selection, surgical approaches, and the emerging role of hemiarthroplasty are thoroughly explored, showcasing a commitment to improving patient outcomes through refined surgical practices and clinical judgment.
Ultimately, Jenkins advocates for a tailored approach where surgeons focus on effectively fixing feasible fractures while being prepared to resort to replacement if necessary, underlining the significance of patient-centered care in orthopedic surgery.