Does surgeon specialization change the proximal humeral osteo-synthesis approach?

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Abstract

Objective: To evaluate the choice of surgical approach among Brazilian orthopedists and whether shoulder surgery specialty training or duration of experience influences the decision-making. Methods: A questionnaire on the preferred approach and complications was administered to orthopedic surgeons with and without shoulder specialization training. The chi-square test or Fisher's exact test was applied. Results: We interviewed 114 orthopedists, 49 (43.0%) traumatologists, 36 (31.5%) specialist surgeons, and 29 (25%) shoulder surgery specialist residents. In cases of fracture without dislocation, specialized training and duration of experience did not influence the approach used (primarily deltopectoral). In cases of fracture/dislocation, 97.2% of the specialists versus 82.1% of the traumatologists opted for the deltopectoral approach (p = 0.034). In cases of fractures/dislocation, 92.5% of surgeons with more than 5 years of experience and 78.7% with less than 5 years of experience opted for the deltopectoral approach (p = 0.032). Conclusion: Specialization in shoulder surgery did not influence surgeons' approaches to manage fractures without dislocation. In cases of fracture/dislocation, shoulder surgery specialization training and duration of experience were associated with selection of the deltopectoral approach. Level of Evidence V, Expert opinion.

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Mouraria, G. G., de Souza, P. de A. M., Saheb, R. L. C., Cruz, M. A., Moratelli, L., & Etchebehere, M. (2019). Does surgeon specialization change the proximal humeral osteo-synthesis approach? Acta Ortopedica Brasileira, 27(2), 113–115. https://doi.org/10.1590/1413-785220192702212055

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