Please login to view this media
- Talk
- 20/09/2023
- UK
BIOS Decision Making in Orthopaedic Surgery - To Operate or Not To Operate : Amar Rangan
Description
In this insightful presentation, Dr. Amar Rangan discusses the challenges and considerations involved in managing a patient with a proximal humeral fracture, particularly in the context of the patient having only one functioning arm due to a previous amputation. He raises the question of whether to operate or manage the fracture non-operatively, emphasizing the reliance on imaging such as CT scans and the limitations they present. Dr. Rangan highlights a significant study by Addie Majed, which explored the classification of proximal humeral fractures through 3D reconstructions, noting the modest interobserver agreement among experts, underscoring the complexity of these injuries.
As the case unfolds, Dr. Rangan narrates the subsequent surgical intervention which, despite being performed under the assumption of straightforward recovery, leads to complications such as septic necrosis. He engages the audience in a dialogue about surgical outcomes versus non-operative management based on current evidence from the PROFHER trial, suggesting that surgical treatments do not consistently yield superior results compared to non-surgical options. The discussion culminates in reflecting on the implications for clinical practices, calling for a balanced approach to treatment decisions while emphasizing the need for more personalized and evidence-based management strategies.