The Upper Hand: Chuck & Chris Talk Hand Surgery

Y’all said you continue to accept recs for show topics… what about Tetraplegia- tendon transfers versus nerve transfer. Maybe with guest gurus… I’m currently reading about this population in Rehab of the hand and it has peaked my curiosity.

Like Dr Dy, I finished fellowship ten years ago. I have had great mentorship after fellowship but I also would have welcomed this podcast when I was a trainee and new attending. I am so gratified to have some of my own observations verified, and to learn some new things too. I was at a Wash U type place where “if we won’t do it, no one will” and had to learn quickly. Also great: Dr Boyer’s “ never miss the opportunity to do nothing.”

Loved this and learned so much in medical school for all things CTS wrist, hand and elbow! Dr. Chuck is inspiring me to go back for a MBA! Dr. Chris’ shared on his athletic endeavors are fun too. Keep up the great work and thanks for lending a hand! -Dave James ND Naturopathic Physician Preceptee

As a Hand APC this podcast has been a favorite of mine to listen to on the way to the hospital. I appreciate the conversations about different approaches to patient cases, pitfalls, and pearls. Simply great and easy to listen to. - as a side note, there was an episode on hand therapy for finger fractures. Macey had briefly touched on the idea of hydro-dissection with stenotic flexor tendons. I have had two similar patients. One with a hyper extension injury to 2-5 MCPs. As they had plateaued in therapy after 4 months and had mild tenderness with palpation on they A1 pulley I had done a flexor tendon sheath injection at the level of the pulley for one finger as something to try that we hadn’t. 2 days later patient had made notable gains in therapy describing it as a “night and day difference”. I went ahead and injected the other digits, and again very quickly after the injections the motion increased. What was interesting to me was the thickness and resistance that I had felt with the needle as I entered through the A1 pulley. I keep a finger at the level of the middle phalanx and near A0 to insure I am in the sheath. Long story short- I am intrigued at the possibly of hydro dissection for flexor tendon stenosis and think it may have value and avoid potential flexor tenolysis surgeries in some patient populations Allyssa