Shoulder and Elbow Terrible Triad

Description

This video transcript covers a medical discussion focused on surgical techniques and outcomes related to shoulder and elbow injuries, specifically, hemiarthroplasties and shoulder fractures. The presenters outline controversies regarding the efficacy of hemiarthroplasties compared to other surgical options, citing studies showing poorer outcomes in older patients (70+) compared to younger ones (40s). They also discuss specific cases, including a challenging shoulder fracture in a 40-year-old diabetic woman and a subsequent failed surgery that required revision. The conversation shifts to the importance of surgical technique and decision-making in cases of complex fractures, including indications for using three-dimensional CT scans for better pre-operative planning.



The second part of the discussion addresses the impact of surgical approaches on the outcome of open reduction and internal fixation of distal humeral fractures. The presenters share insights on the biomechanical aspects of different plating techniques, stressing the importance of screw placement and stabilization constructs to avoid complications such as nonunion or plate breakage. They mention specific surgical approaches and techniques such as the Olakunrin osteotomy and triceps reflection, highlighting their effectiveness in providing adequate exposure for repair.



Throughout, there is an emphasis on the need for experienced surgical teams and appropriate pre-operative assessments to ensure successful outcomes in challenging cases. The presenters advocate for individualized approaches based on the specifics of each injury, patient factors, and up-to-date medical literature. The discussion concludes with a call for awareness of common pitfalls in treating complex elbow and shoulder injuries.

DOI: 10.1302/3114-221724

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