Description
In this presentation, trauma surgeon Charlotte Lewis discusses the management of humeral shaft fractures, emphasizing the considerations involved in choosing between bracing, nailing, or plating as treatment options. She begins by highlighting the importance of proper operating theater setup, particularly during patient positioning to protect the radial nerve. Charlotte compares different positioning strategies such as the traditional beach chair position versus supine positioning for better access and safety during surgery.
She elaborates on the absolute indications for surgery and the risks associated with non-operative treatment, such as non-union and complications like infection. Case studies illustrate her points, highlighting individual patient factors that influence the decision-making process for surgical versus non-surgical intervention. She notes that patients who are non-compliant with bracing or who present with more complex fracture patterns may require surgical fixation sooner.
Charlotte also stresses the importance of regular follow-ups in non-operative cases to monitor healing, advising caution especially with factors that may predispose patients to poor outcomes such as alcohol use and existing comorbidities. Ultimately, she advocates for a considered approach to surgical intervention, emphasizing that the correct operation at the outset is crucial for successful patient outcomes.