Description
In this presentation, Andrew Duckworth from the Royal Orthopaedics in Edinburgh discusses significant recent papers on upper limb issues, specifically focusing on shoulder conditions and management strategies for rotator cuff tears. He highlights the increasing prevalence of rotator cuff tears with age and the rapid rise in surgical interventions over recent decades, noting that while non-operative and operative management options are debated, a recent systematic review suggests benefits to both approaches that remain inconclusive. Duckworth presents findings from a multicenter longitudinal cohort study comparing outcomes between non-operative treatments and surgery for rotator cuff tears, revealing nuanced results such as quicker early improvement in non-operative management but later benefits from surgical approaches. He emphasizes the need for robust randomized controlled trials to better understand the optimal management strategies for rotator cuff disease.
Duckworth then shifts focus to various types of fractures and injuries, including humeral shaft fractures and olecranon fractures, discussing the growing body of literature suggesting non-operative management of these conditions may yield favorable outcomes, particularly in elderly patients. He summarizes multiple studies indicating that elderly patients often tolerate malunion better than previously thought and that effective joint decision-making is crucial. Lastly, he discusses distal radius fractures in the geriatric population, addressing the roles of non-operative versus surgical interventions and their implications on patient outcomes, aspiring to reflect the evolving landscape of upper limb management in orthopedic practice.