Priority 1 from the Broken Bones of the Upper Limb in People over 50
|UNCERTAINTY: What are the most important outcomes after an upper limb fracture in people over 50 including physical, psychological and financial effects? (e.g. time for the bone to heal / return to normal activities / time to achieve a good recovery / cosmetic appearance) (JLA PSP Priority 1)|
|JLA question ID||0093/1|
This was a combination of two indicative questions that was formed at the 'Final Workshop'.
1. What are the most important outcomes after an upper limb fracture? (eg. time for the bone to heal / return to normal activities / time to achieve a good recovery / cosmetic appearance)
2. What physical, psychological and financial effects do upper limb fractures have on people over 50 and their families?
Upper limb fractures can have a significant impact on a patient’s life, from a physical, psychological and financial aspect. Enabling a patient to do everything they could do before breaking their arm is the main priority of treatment, however, this is not always possible. How do we judge whether a patient’s treatment has been successful? This question aims to determine what the most important aspects of a patient’s recovery are. Uncertainties included whether patients would achieve their pre-injury level of function and how long this may take; how they would be affected psychologically (such as fear of falling); and how it would impact on them financially. It also included whether there were any factors we could use to predict these outcomes.
Jayakumar, P., et al.; The use of computer adaptive tests in outcome assessments following upper limb trauma: A SYSTEMATIC REVIEW. The Bone & Joint Journal Issue: Volume 100B(6), June 2018, p 693–702
Jayakumar P, Williams M, Ring D, Lamb S, Gwilym S. A Systematic Review of Outcome Measures Assessing Disability Following Upper Extremity Trauma. J Am Acad Orthop Surg Glob Res Rev. 2017;1(4):e021. Published 2017 Jul 27. doi:10.5435/JAAOSGlobal-D-17-00021
|Health Research Classification System category||Injuries and Accidents|
|Extra information provided by this PSP|
|Original uncertainty examples||How long will it take for the injury to heal and how long before I can resume normal movement? ~ Predictive questions about the likelihood of regaining full strength and movement. ~ What are the outcomes surgery vs conservative management? ~ How long can I expect treatment to last before the fracture is healed? ~ What are the costs loss of income/jobs due to upper limb injuries/fractures (example, taxi drivers etc.)?|
|Submitted by||49 x Healthcare Professionals, 61 patients, 6 Carers/ relatives, 3 x not stated|
|PSP unique ID||0093|
|PSP name||Broken Bones of the Upper Limb in People over 50 PSP|
|Total number of uncertainties identified by this PSP.||50 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)|
|Date of priority setting workshop||3 December 2018|