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With the increase of superspecialisation, there has been a recent trend for a rising number of operations for both trauma and orthopaedic ailments. This flies against the results of properly planned, well performed, adequately powered, with clinically relevant outcome measures and long enough follow-up level I studies which challenge the received wisdom that surgery is actually superior to conservative management or even supervised neglect. This editorial outlines some of these issues, and suggests that orthopaedic and trauma surgeons should actually think twice before operating on anything that comes our way.