Description
Steve Gwilym presents his insights on proximal humeral fractures, focusing on the complexities of treatment options such as ORIF, conservative management, hemiarthroplasty, and reverse arthroplasty. He shares his experience from Oxford, expressing the challenges in achieving satisfactory outcomes for patients with these fractures, often feeling that the relationship between X-ray results and patient satisfaction is poor. Gwilym outlines four critical decision points affecting outcomes: the initial injury, the choice to operate, patient compliance with recovery protocols, and the implications of remote follow-ups. He emphasizes the importance of patient engagement and fears surrounding movement post-injury, underlining that proactive patient management correlates to better recovery results. Gwilym discusses the ongoing PROFHER trials aimed at better understanding treatment efficacy, while also highlighting the role of surgeon expertise and the necessity of incorporating patient education and activation into recovery protocols. He concludes that orthopedic practices must evolve beyond traditional surgical decision-making, focusing more on holistic patient management strategies to improve outcomes.
DOI: 10.1302/3114-210334