Priority 13 from the Broken Bones of the Upper Limb in People over 50

UNCERTAINTY: When is the best time to operate on an upper limb fracture in people over 50 and does a delay in surgery influence outcomes? (JLA PSP Priority 13)
Overall ranking 13
JLA question ID 0093/13
Explanatory note Some upper limb fractures require an operation, however, we do not know what is the best time to perform this surgery to ensure a patient has the best chance of full recovery. There can be many reasons why this surgery can be delayed but does this delay lead to a patient having a worse recovery?
Evidence

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

Health Research Classification System category Injuries and Accidents
Extra information provided by this PSP
Original uncertainty examples How early on is surgery most effective? ~ Processes involved reducing time from injury to intervention ~ What will happen if the operation is delayed? ~ What is the optimal timing (as determined by clinical outcome) for surgery for displaced intra- articular fractures of the distal radius.
Submitted by 9 x Healthcare Professionals, 14 Patients, 3 x Carers/Relatives
PSP information
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