Description
In this presentation, Andrew Duckworth discusses recent findings in upper limb trauma, focusing on the management of humeral shaft fractures. He highlights the shift in literature regarding non-operative versus operative treatments, referencing historical debates and advancements in research. Duckworth presents a systematic review indicating that non-operative management leads to a higher non-union rate compared to surgical fixation. He also mentions a multi-center study focusing on the reasons behind surgical conversions from non-operative management, identifying non-union as a significant factor.
Moving on, Duckworth addresses the balance between the benefits and risks of both treatment methods, emphasizing that while non-operative management shows a considerable success rate, it comes with potential complications, such as iatrogenic nerve injuries from surgery. He reviews a recent randomized controlled trial comparing operative and non-operative management for closed displaced humeral shaft fractures, noting the lack of significant differences in outcomes between the two methods after one year.
The discussion also includes insights on distal biceps tendon injuries, the variability in treatment approaches, and a systematic review focusing on return-to-work rates following surgical repair. Duckworth introduces the importance of classifying olecranon fractures and evaluates recent research on surgical techniques for these injuries, drawing attention to the reliability of the Wrightington classification system.
Each section culminates in the recognition of emerging evidence and the necessity for targeted treatment approaches tailored to individual patient needs, while also identifying the limitations of current studies. Duckworth concludes by urging further investigation into optimal management strategies for upper limb fractures.