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The Upper Hand Podcast feature Charles Goldfarb and Chris Dy from Washington University Department of Orthopedic Surgery. Our weekly podcast will discuss all things hand surgery, from the technical aspects of what we do (diagnosis, treatment) to our more personal approaches to events and opportunities that hand surgeons experience. We welcome feedback and audience engagement. We are grateful for the muscial contribution of @iamPeterMartin.
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Chuck and Alpesh Patel, Professor of Orthopedic Surgery and Neurosurgery at Northwestern, discuss artificial intelligence and its role in medical practice. In the first of a two- part discussion, Chuck and Alpesh start with the basics on what AI is and what it can reasonably do and they start to delve into more details around practical applications…
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Chuck and Chris have a good discussion based on several questions submitted by Chris Gayton at Ortho South Carolina and share why we are thankful at this time of year. We discuss when we consider carpal tunnel release and cubital tunnel surgery together, when we consider a distal ulnar tunnel decompression, and the role of dry arthroscopy in the se…
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Chuck and Chris discuss advocacy. In this episode, we start with an adolescent elbow case as a warm up and then pivot to advocacy. Starting with a simple definition and explaining why it is so important for all of us. We use practical examples for discussion on all types of advocacy and why we should all engage in some manner. Jon Lundy can be reac…
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Chuck and Chris discuss Bennett Fractures and Rolando Fractures as well as a few mailbag topics including central TFCC tears (and the role of ulnar shortening) and more on bowstringing from Sam Moghtaderi. A few citations courtesy of loyal listener Joe McLaughlin. 1) Hulsizer, et al. Ulna- shortening osteotomy after failed arthroscopic debridement …
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Chuck and Chris discuss the Darrach procedure including our indications, alternatives, technical considerations, and more. We also share our amazing experiences at the ASHT! Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. See http…
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Chuck joins David Wei, a hand surgeon who leads the Business of Hand Surgery Committee at the ASSH, to discuss a variety of topics. In what is really an interview of Chuck by David, a variety of topics are discussed. David began and leads the BOHS podcast which is an amazing resource of practical business and private practice topics. We had a great…
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Chuck and Chris review the ASSH meeting, preview the ASHT meeting, and discuss a few tricks and tips for ulnar shortening osteotomy through a case presentation. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. See https://checkpoin…
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Chuck and Chris discuss a number interesting listener submitted questions including comments around our SL ligament episode and the rock climbing episode. We even take a (brief) deep dive into biomechanics! We also share out plans for the ASSH Annual Meeting in Minneapolis. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.co…
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Chuck and Chris welcome Sanj Kakar, MD from the Mayo Clinic to discuss the SL ligament. We discuss Sanj's path to his current role and his approach to the SL ligament including diagnosis and treatment. We refer to Scapholunate Instability: Diagnosis and Management e Anatomy, Kinematics, and Clinical Assessment. Part I Lauren E. Wessel, MD,* Scott W…
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Chuck and Chris discuss rock climbing injuries. We review general hand and wrist injuries but focus on the classic injuries to the fingers and flexor tendon sheath. We refer to Upper Extremity Injuries in RockClimbers: Diagnosis and Management byLaura A. Sims, MD. J Hand Surgery 2022; 47:662-72 Subscribe to our newsletter: https://bit.ly/3iHGFpD Se…
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Chuck and Chris provide 7 pearls for graduating fellows before diving into a discussion on spanning plates. Also in this episode- learn some of the ways that Chris is 'risk averse'. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. …
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Chuck and Chris have a good discussion on FDP tendon avulsions and repair options. We discuss whether the FDP should always be repaired in the setting of an intact FDS (a great deal of therapy is required and results are rarely excellent) and we discuss how we each repair the FDP. We also reference a few items: 1) Carroll Tendon Pulling Forceps (th…
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Chuck and Chris welcome Steve Frick to discuss leadership. Steve is an exemplary leader who was Chief of Pediatric Orthopedic Surgery and Vice Chair at Stanford. He is now headed back to Atrium Health/ OrthoCarolina in a leadership role. We sat down with Steve at the annual leadership meeting of the AOA- American Orthopedic Association (and apologi…
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Chuck and Chris talk through the 2024 JBJS 'What's New in Hand Surgery' written by Deb Bohn. We discuss a number of interesting hand surgery topics including: wrist and hand arthritis, distal radius fracture, scaphoid fractures, metacarpal fractures, pediatric injuries, among other topics. Great review of an important review of the literature from …
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Chuck and Chris talk through the 2024 JBJS 'What's New in Hand Surgery' written by Deb Bohn. We discuss only two topics in our part 1- trigger finger and carpal tunnel release. A few key citations from some really interesting topics: 1. Bookman J, Rocks M, Noh K, Ayalon O, Hacquebord J, Catalano L, Glickel S.Determining the optimal dosage of cortic…
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Chuck and Chris catch up on life, travels and cases. We discuss Chuck's recent mission trip with World Pediatrics and pivot to discuss a few cases including care of the phalanx enchondroma and pain at the pisiform. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job …
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Chuck and Chris welcome Amanda Lovelace who is the Marketing Director for our large orthopedic department. We share a fantastic first discussion including marketing directions, the importance of personal relationships, how social can be considered, among many other topics. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com…
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Chuck and Chris begin this episode with a discussion of ray resection and then pivot to discuss practice management and payer mix in our practices as well as the benefits and challenges of workers compensation. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job sear…
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Chuck and Chris are joined by special guest Macy Stonner who brings her therapy expertise to the topic of finger fractures. This episode will revisit common fractures and the therapist perspective to outstanding outcomes. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner …
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Chuck and Chris answer a few listener- submitted questions and then take a deep dive into their approach to finger fractures with a specific focus on Kirshner wires, k-wires. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. See htt…
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Chuck and Chris welcome Ryan Nunley to the Podcast. Ryan is a total joint surgeon who has an amazingly busy clinical practice. We discuss practice efficiency, handling VIPs, and share updates on computer navigation and robotic surgery. There is so much we can learn! Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupp…
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Chuck and Chris discuss patients with dupuytrens disease (in office and in the OR) including our protocols for care after formal surgery. We also discuss some challenges with needle procedures in the office. We touch on our trial of AI for clinic note generation and look forward to listener comments. And finally, we touch on leadership with a deep …
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Chuck and Chris catch up on with listener submitted questions and then discuss the volar approach to the scaphoid for scaphoid nonunions. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. See https://checkpointsurgical.com or www.ne…
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Chuck and Chris catch up on with listener submitted questions on technical aspects of two procedures: a deep dive on CMC arthroplasty with suture tape suspension and the indications for subcutaneous vs submuscular ulnar nerve transposition. We close with a brief discussion of medial epicondyle fractures with ulnar nerve pathology. Subscribe to our …
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Chuck and Chris welcome 2024 and season #5 with a technical episode on the treatment of Kienbocks disease. We discuss patient evaluation and surgical considerations including radius shortening, vascularized bone flaps, carpal pinning, and so much more. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for mor…
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Chuck and Chris with a bonus, year- end episode with listener questions, CMC fusion case discussion, and an HBR review on the importance of positive energy. This was a really a catch- up episode and we catch up on Chris' travel, Chuck's b-school, and other timely topics. HBR: The Best Leaders have Contagious Positive Energy. Emma Seppala and Kim Ca…
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Chuck and Chris welcome Tony Smith and Steve McCabe to discuss the founding of the Hand Society and Sterling Bunnell. The two have been on an amazing journey of primary research to learn more about Sterling Bunnell. They share insights with us in advance of their expected biography. Join us for some exciting history of hand surgery. Subscribe to ou…
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Chuck and Chris discuss the adolescent medial epicondyle fracture and a group of patients with a challenging outcome. This deep dive into the pathology and the technical considerations for treatment help us better understand the fracture, the relationship of the ulnar nerve, and more Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.pract…
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Chuck and Chris build on a hand society symposium led by Don Lalonde- What to Say and What not to Say to patients. Chuck and Chris discussion tips to build the patient relationship and challenges in doing so. We look forward to your thoughts and your tips. We also discuss the medical school tradition of the white coat ceremony! Subscribe to our new…
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Chuck and Chris have a brief discussion about Chuck's Executive MBA program and then take a deep dive on a laceration in the distal forearm- the so- called spaghetti wrist. We talk details including the technical aspects of the procedure and patient expectations. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperh…
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Chuck and Chris are joined my Marschall Berkes, Chief of Orthopaedic Trauma at Washington University Orthopedics to discuss clavicle fractures. Recognizing that many hand surgeons treat the entire upper extremity including clavicle fractures, Marschall's perspective will be interesting to many listeners. We discuss indications, approach, technique,…
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Chuck and Chris discuss the Hand Society meeting in Toronto including the highlights for each of them. They also discuss a pediatric elbow case including dome osteotomy treatment. And, if you listen to the end, you will learn more about the Drake show in Toronto! Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperh…
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Chuck and Chris discuss a three new Journal of Hand Surgery articles for our podcast journal club. Join us and share any thoughts! Isaacs, Nydick, Means, Merrell, Ilyas, Levine and RECON study group. A multicenter prospective randomized comparison of conduits versus decellularized nerve allografts for digital nerve repairs. JHS 2023 Guidi, et al Di…
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Chuck and Chris welcome Macy Stonner back for an in depth discussion of CMC arthritis and post surgical management. As usual, Macy brings great insights which are pertinent for anyone caring for patients with thumb pain. We also discuss a listener submitted question on the differences between TMR and RPNI. Subscribe to our newsletter: https://bit.l…
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Chuck and Chris start with a brief discussion on coding before taking a deeper dive on acute median nerve repair based on a listener question regarding tension during repair (tension on the nerve, not tension of the surgeon). We then pivot to volar scaphoid approach and pearls. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelin…
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Chuck and Chris start with a deep dive on a few technical points with ulnar nerve surgery. Next we tackle a listener question on management of hook of the hamate fractures. And finally, we discuss life as a busy clinician and how we respond to different requests- it can be ok say 'no' to academic/ life requests if there simply is no time. Subscribe…
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Chuck and Chris are joined by a special guest, Megan Conti Mica currently at the University of Chicago. The three of us catch up a bit with a hand club discussion before diving in to a technical discussion of distal radius malunion. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from o…
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Chuck and Chris discuss use a listener submitted case as the basis of a discussion of the PIP joint. We break down treatment considerations for a dorsally subluxated PIP joint that is stiff in extension. Dive in with us- complicated discussion! We also briefly touch on FPL ruptures, the rheumatoid hand (and the disappearing art of treating it). The…
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Chuck and Chris discuss the 4th of July and fireworks injuries. We review the most common presentations and treatment including acute and delayed. We then pivot to review three interesting and recent publications. Bulstra and the Machine Learning Consortium, "A Machine Learning Algorithm to Estimate the Probability of a True Scaphoid Fracture after…
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Chuck and Chris spend a few minutes catching up before taking a deep dive into the assessment and care of the scaphoid nonunion. We discuss general approach before discussing the technical details of fixation. Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job searc…
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Chuck and Chris catch up before and after some major travel and then dive into the impact of patient age on treatment decisions. We use scaphoid fractures and cubital tunnel as the basis of this discussion. Do we make inappropriate assumptions about young patients' healing abilities? And when we operate, do we treat patients differently- what's the…
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Season 4, Episode 15. Chuck and Chris discuss community and what it is so important. We begin, however, discussing kids, coaching and other activities before pivoting into a discussion on burnout and how community helps! More and more brunout is a topic that matters. While time away from work and time with family is one burnout remedy, another is c…
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Chuck and Chris share a live podcast from Singapore at the 13th Congress of the Asian Pacific Federation of Societies for Surgery of the Hand, the 9th Congress of the APFSHT, and the 8th APWA. We are grateful to many for this opportunity, especially Soumen Das De. We interview Dr. Yuan-Kun Tu from Taiwan who is known internationally for his positiv…
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Season 4, Episode 13. Chuck and Chris spend the first 20 minutes of this nearly hour- long episode discussing past and future travel- the meetings, the patient care challenges, etc. Then we pivot to deep dive with a discussion on a case of FPL rupture after volar plating of a distal radius fracture. While uncommon, this problem can be a real challe…
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Unsolved Problems in Hand Surgery: JHS European based discussion on Kienbocks and CMC Instability
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Season 4, Episode 12. Chuck and Chris welcome two amazing guests: Mireia Esplugas from Barcelona, Spain and David McCombe from Melbourne, Australia. Our guests join us to discuss the March 2023 special issue of JHS European, Unsolved problems in hand surgery. David McCombe was the guest editor of this special journal. We chose two articles to discu…
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Season 4, Episode 11. Chuck and Chris welcome Macy Stonner back, our good friend and friendly hand therapist extraordinaire! Macy will lead our discussion on mallet fingers. She will share tips and tricks and we will all share our thoughts about this 'routine' but sometimes challenging diagnosis. Subscribe to our newsletter: https://bit.ly/3iHGFpD …
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Season 4, Episode 10. Chuck and Chris take a deep dive into Deborah Bohn's What's New in Hand Surgery in JBJS, part 2! Chuck also drops some news on a new endeavor. JBJS 2023; 105:428-34 Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunit…
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Season 4, Episode 9. Chuck and Chris take a deep dive into Deborah Bohn's What's New in Hand Surgery in JBJS. The article covers key new articles into our favorite research topics in hand surgery. This is Part 1 of a two part series. JBJS 2023; 105:428-34 Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for …
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Season 4, Episode 8. Chuck and Chris record a second episode in Las Vegas during the AAOS. We start by talking Vegas and Chris' dining choices. We discuss research pathways recognizing Chris's amazing accomplishment of winning the Kappa Delta Young Investigator Award. We share reflections on our recent fellowship interview day (and the remarkable c…
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Season 4, Episode 7. Chuck and Chris gather in Las Vegas during the AAOS meeting and spend some catching up. The bulk of this podcast is Chris' interview with Lee Dellon, who has retired and is living in Las Vegas. Dr. Dellon has done a great deal to advance the field of nerve surgery - authoring numerous publication, training many of today's nerve…
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