Priority 8 from the Broken Bones of the Upper Limb in People over 50
|UNCERTAINTY: What is the best surgical management for an upper limb fracture in people over 50? (e.g. incision, technique, metalwork, technology) (JLA PSP Priority 8)|
|JLA question ID||0093/8|
|Explanatory note||Some patients who have broken their arm will require an operation to help the bone heal. This question looks to determine what is the ideal way that we operate on specific upper limb fractures to optimise recovery and prevent complications, such as long-term pain. Uncertainties focused on the method of incision and surgery; the type of metalwork used; and whether we can use technology to improve surgical techniques (such as using 3D printing or virtual surgery).|
National Institute for Health and Care Excellence. Fractures (non-complex): assessment and management (NG38). London: NICE, 2016.
The British Society of Surgery for the Hand. Best Practice for management of Distal Radius Fractures (DRFs). BSSH, 2018
For full details of the evidence checked, please see the spreadsheet of data held on the JLA website.
|Health Research Classification System category||Injuries and Accidents|
|Extra information provided by this PSP|
|Original uncertainty examples||Is IM nailing for 3 and 4 part fractures of shoulder Better than plating ? as this can be done through less surgical dissection? ~ What is the role of type of humeral implant in optimising results in hemiarthroplasty for proximal humeral fractures? ~ Are there alternatives to hook plate for distal clavicle fractures?|
|Submitted by||11 x Healthcare Professionals, 4 x Patients, 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|