Description
The presentation by Joe Dias at the Edinburgh International Trauma Symposium focuses on the treatment of scaphoid fractures, a common wrist injury. He begins by expressing gratitude for the invitation and acknowledges the challenges faced during the ongoing pandemic, hoping for future in-person events. Dias outlines the structure of his talk, which includes the historical context of scaphoid fracture treatment, the pros and cons of surgical intervention, patient communication, and decision-making strategies.
He discusses the trend toward normalization of surgical fixation for scaphoid fractures, highlighting how the rates of acute fracture fixation increased significantly in the UK from 2007 to 2010. Citing a study conducted in partnership with the NIHR, Dias shares findings that show minimal differences in outcomes between surgical fixation and conservative treatment with a cast. Notably, the complication rates associated with surgery were higher than those seen in conservative management.
The discussion includes technical details about the procedure of internal fixation, including the use of Kirschner wires and headless screws, and highlights the varying experiences from recent data regarding postoperative complications, such as screw protrusion and infection. He emphasizes that scaphoid fractures should be treated based on their displacement, advising that fractures with less than 2 millimeters of displacement can be treated conservatively, while those with greater displacement may warrant surgical intervention.
Finally, he outlines various clinical scenarios that may necessitate surgical fixation and reiterates the importance of patient discussions regarding treatment options and potential risks. Through this comprehensive examination, Dias delivers insights on balancing effective treatment strategies with patient safety and outcomes.