Example of change of attitude

As I wrote yesterday, in some injuries and conditions, it is very hard for us surgeons to say is it better to operate or treat nonoperatively. Echalier et al. conclude in their study:

This study supports open reduction and internal fixation with an anatomical plate of displaced fractures of the middle third of the clavicle since the functional recovery is better in the first 6 weeks.

Their results quite clearly show that patients indeed improve faster with operative treatment. But nonoperatively treated patients achieve almost the same functional results eventually but it just takes longer. If operative treatment results to FASTER recovery, it is certainly an important aspect to consider in decision making. But since operative treatment does not result to BETTER recovery, in the end it´s all subjective whether operative treatment is better than nonoperative. It is value-laden and it´s up to the patient which he/she prefers. Each treatment option has it´s pros and cons. Patients decides which is better, not surgeons.

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