The Upper Hand: Chuck & Chris Talk Hand Surgery

Episode 27.  Chuck and Chris talk tennis elbow.  We discuss the key pertinent features of the history and the physical examination including key differential diagnoses.  We review the role of nerve studies for radial tunnel as well as the role of diagnostic injection.  We begin the discussion of treatment with therapy. We hope for feedback from listeners. As always, thanks to @iampetermartin for t...

Episode 26.  Chuck and Chris talk side gigs or side hustles.  Clearly, our clinical work is consuming but there are benefits to side gigs including simply engaging in pursuits outside of typical medical care and many side gigs can be helpful in minimizin the risk of burnout.  Chuck and Chris discuss 7 common side gigs.  We hope for feedback from listeners. As always, thanks to @iampetermartin for...

Episode 25.  Chuck and Chris discuss education.  In this episode, we review how we view educational changes over the last 20 years, key mentors and role models, how to prepare from the OR, and the benefits of a post- surgery review for each case.  We share thoughts on the value of the cadaver lab (hint: invaluable) as well as the use of video in preparation for the OR and surgical simulation as we...

Episode 24, is part 2 of Chuck and Chris' discussion with guest Sam Moghtaderi, MD on wide awake local anesthesia no tourniquet (WALANT) surgery.  We discuss surgical tips and pearls, education, and challenges in the OR and at the system level.  Sam's experience with WALANT provides unique insights for the listeners. theupperhandpodcast.wustl.edu As always, thanks to @iampetermartin for...

Episode 23, Chuck and Chris welcome guest Sam Moghtaderi, MD to discuss wide awake local anesthesia no tourniquet (WALANT) surgery.  We discuss specific approaches to the patient consent process, specific surgical tips and pearls, and challenges in the OR and at the system level.  Sam's experience with WALANT provides unique insights for the listeners. theupperhandpodcast.wustl.edu As always,...

In Episode 22, Chuck and Chris discuss ulnar sided wrist pain, focusing on treatment of TFCC pathology.  We review the treatment of TFCC tears including arthroscopic and foveal repairs.  We discuss therapy and reasonable expectations after surgery. We reference the Foveal Repair J Hand Surg Am 2018 Jul;43(7):680.e1-680.e5.   As always, thanks to @iampetermartin for the amazing introduction and con...

In Episode 21, Chuck and Chris discuss ulnar sided wrist pain, focusing on diagnosis.  We review the differential diagnosis including diagnostic categories and how we work through the history and physical examination.  We discuss key examination maneuvers and diagnostic tests including imaging and injections. We reference the ECU Synergy Test: Ruland and Hogan, J Hand Surg Am 2008 Dec;33(10):1777-...

Episode 20.  Chuck and Chris welcome Macyn Stonner, OTD, an amazing hand therapist with Milliken Hand Therapy in the Program of Occupational Therapy at Washington University.  We discuss the challenge of these injuries including our surgical preferences and spend more time with Macy discussing therapy.  Macy pulls back the curtain and shares her approach to treating these patients and working towa...

In Episode 19, Chuck and Chris discuss the diagnosis and assessment of thumb UCL injuries including the role of advanced imaging.  We then discuss our treatment approaches on the operative and nonoperative care including patient counseling.  We focus our operative discussion on the role of the classic repair techniques versus the use of suture tape. As always, thanks to @iampetermartin for the ama...

Episode 18.  Our third guest on the Upper Hand Podcast is Marybeth Ezaki, MD.  Dr. Ezaki is past President of the ASSH and remains the only female president of this organization.  She is a critical thinker in the field of congenital hand surgery and is a mentor to many surgeons who practice in this field.  She shares thoughts on women in surgery, dogma, and the evolution of hand surgery.   As alwa...

Episode 17.  Chuck and Chris discuss various dogma in hand surgery including topics such as cubital tunnel syndrome, metacarpal fractures, the development of wrist arthritis, etc.  Join us and weigh on via twitter or email on dogma topics in hand surgery. As always, thanks to @iampetermartin for the amazing introduction and conclusion music. theupperhandpodcast.wustl.edu

Episode 16: Chuck and Chris discuss patient centered care and decision aides in the context of thumb basal joint arthritis.  This episode also marks our Facebook Live debut for Washington University Orthopedics and the conversation reflects a bit more of a patient focused approach.  We also welcome the debut of a future podcast star- Chris' son Raffi! As always, thanks to @iampetermartin for...

Episode 15.  Our second guest on the Upper Hand Podcast is the current President of the American Society for Surgery of the Hand, Martin I. Boyer, MD.  In our conversation with Dr. Boyer, we learn about his plans for his presidential year, focused on fellow education.  We also learn about the response of the ASSH to COVID-19-  with a concerted and highly effective effort to provide timely informat...

Episode 15: Chuck and Chris review Chris' JBJS review on the hand surgery literature for 2019.  This is the second part of the discussion of scaphoid nonunions, the role of denervation, tendon, replantation, and a brief discussion of opioids.  theupperhandpodcast.wustl.edu As always, in these stressful times, I always recommend more @iampetermartin- jazz piano relaxation.

Episode 14: Chuck and Chris discuss Chris' 2020 JBJS review on the hand surgery literature for 2019.  This is Part I of II with a discussion of thumb CMC arthritis and distal radius fractures, among other topics. Because of the crazy times, we also give some COVID-19 updates.   theupperhandpodcast.wustl.edu And, in these stressful times, I always recommend more @iampetermartin- jazz piano rel...

Chris and Chuck review the impact of the COVID-19 pandemic on our community and our practices, our training program, and we share some of the adjustments that have been made.  We recognize the rapid pace of change and the variability from community to community, state to state, and country to country.  

Episode 11 evaluates 7 clinical pearls that Chuck and Chris use to maximize their practice efficiency.  We hope that our discussion of these tips and tricks provide something for you to consider in your own practice.  Really this is Chuck and Chris sharing some of our favorite pearls that we believe make us better hand surgeons (and give us more time for the personal and non- clinical work activit...

Our first guest on the Upper Hand Podcast is the Journal of Hand Surgery Editor in Chief, Brent Graham.  We learn about Dr. Graham's training, career, and path to Editor.  We learn more about Dr. Graham's insights into the world of hand surgery and journal editing.  Dr. Graham also hosts a podcast for the Journal of Hand Surgery, so he is no stranger to this medium.   As always, thanks t...

Episode 10. 7 Wack Gigs explores what we can learn when surgeries don't go quite like we planned.   Wack definition- "bad, messed up".  Gig definition- "live musical performance' We are indebted to @iampetermartin for both his music and the concept of exploring this concept.  We evaluate what we can learn when surgeries veer off the planned path.  We share 7 lessons that C...

In Scaphoid 2, we discuss our most common strategies for operative management, including when and how to go dorsal vs volar, when and how we like to use bone graft, and when angular correction is needed. We review our postoperative protocols for immobilization, therapy, and return to activity.  Technical pearls shared.  Thank you to @iampetermartin for his musical contribution.

Scaphoid 1.  In this episode, we discuss the diagnosis of scaphoid fractures including the role of advanced imaging.  We then discuss our approaches on the operative and nonoperative care including patient counseling.  In this episode, we focus our operative discussion on the dorsal approach including tips and technical tricks for the surgical approach.  Thanks to @iamPeterMartin for the amazing m...

Chris and I talk about the technical aspects of carpal tunnel surgery including our approach, open versus endoscopic, and other controversies.  Thanks to @IamPeterMartin for the amazing jazz piano.

We talk about one of the most common diagnoses in any upper extremity surgeon's practice- carpal tunnel syndrome.  This episode is mostly about our approach to the patient and the steps we take in assessing the patient and making a diagnosis.  We review important considerations such as: key patient complaints, which diagnostic tests help most, and how we use steroid injections.  Thanks to @Ia...

We discuss our general approach to metacarpal fractures, which were recently in the news due to Steph Curry’s injury. We talk through our decision tree, how we treat non-operatively, how we treat surgically, and return to activity/play considerations.

Learn a little more about your co-hosts and why we decided to launch a podcast about hand surgery. Chuck describes his experience with a highly successful patient education blog. Chris describes his failed blog and his hot/cold relationship with Twitter.