this paper will change your practice · 1/17/16 5 lessons n myths: n “it’s too distal for a...
TRANSCRIPT
1/17/16
1
This Paper Will Change Your Practice: Upper Extremity
David Ring MD, PhD
Lessons
n Deformity doesn’t correlate with impairment
n Impairment doesn’t correlate with symptoms and limitations
n Surgery adds injury and potential problems
Lessons
n Expertise sensitive n Preference sensitive n Adaptation and resiliency are good for you
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4
Lessons
n Not all fractures can be fixed and moved n It’s OK to immobilize a joint n The bone on the other end of the joint can
help you with alignment and fixation
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5
Lessons
n Myths: n “It’s too distal for a brace” n “The elbow will get stiff”
This fracture doesn’t benefit from surgery
Lessons
n Recovery is counterintuitive n Pain trips the alarm n Treatment
n Empathy n Expertise n Resume normal life roles
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Lessons
n Surgeons have different opinions and preferences for treatment
n We are at risk of an error in diagnosis of patient preferences