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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 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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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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Season 4, Episode 6. Chuck and Chris gratefully review comments from listeners with a few listener questions sprinkled in. And, we review a few cases with some interesting perspectives on revising an ulnar nerve and lengthening bone (Different cases). Subscribe to our newsletter: https://bit.ly/3iHGFpD See www.practicelink.com/theupperhand for more…
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Season 4, Episode 5. Chuck and Chris are back, on our new every other week schedule. In this episode, we discuss take-aways from two recent ASSH Webinars, one on wrist arthroscopy and one on the ulnar nerve. Then, we take a deep dive on an HBR article, "How to Work with a Workaholic Colleague". HBR, Feb 2023, written by Melody Wilding. Subscribe to…
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Season 4, Episode 4. Chuck and Chris discuss major technical changes to their surgical practices as well as a few practice management changes. Learn how we now approach ulnar nerve transposition, cmc arthritis, and other procedures differently today compared to 5 years ago. We also share a MAJOR announcement- tune in and learn what's changing about…
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Season 4, Episode 3. Chuck and Chris discuss Chris' visit to the AAHS in South Florida and then discuss practice development. We brainstorm the best techniques to make others in the community, region, and medical world aware of your interests. First, of course, take great care of patients. And then... Join us and learn more! Subscribe to our newsle…
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Season 4, Episode 2. Chuck and Chris return after one week off to catch up and begin a discussion on claw hand. We describe presentation and etiology and start to discuss surgical treatment. More to come on this topic. Referenced manuscript: Goldfarb CA and Stern PJ Low Ulnar Nerve Palsy Journal of the American Society for Surgery of the Hand, Feb …
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Season 4, Episode 1. In our inaugural episode for season 1, Chuck and Chris welcome Amy Moore and Dominic Power to discuss nerve! Specifically, in this journal club format we review 4 recent JHS European articles as a format to discuss current concepts in diagnosis and treatment of carpal tunnel syndrome. Amy and Dom share their extensive experienc…
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Season 3, Episode 50. Chuck and Chris welcome Michael Galvez from Valley Childrens Hospital to discuss DE&I in hand surgery. Michael co-edited, with Kevin Chung, the latest edition of Hand Clinics with a number of outstanding contributions from hand surgeons across the United States. This volume of Hand Clinics has insights and practical recommenda…
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Season 3, Episode 49. Chuck and Chris continue with this 4 part segment on radial nerve injuries. In this podcast, Macy joins us to discuss her role in patient assessment and her perspective on both tendon transfers and nerve transfers to address radial nerve injury/ palsy. Subscribe to our newsletter: https://wustl.us6.list-manage.com/subscribe?u=…
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Season 3, Episode 48. Chuck and Chris continue with this 4 part segment on radial nerve injuries. In this podcast, we discuss tendon transfers as treatment for the radial nerve injury. We discuss the three key transfers including wrist extension, thumb extension/ retropulsion, and finger MCP joint extension. We plan one additional episodes on thera…
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Season 3, Episode 47. Chuck and Chris continue with this 4 part segment on radial nerve injuries. In this podcast, we discuss nerve transfers as treatment for the radial nerve injury. We plan additional episodes on tendon transfer and therapy in this series. References: Ray WZ, Mackinnon SE. Clinical outcomes following median to radial nerve transf…
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Season 3, Episode 46. Chuck and Chris begin the first of a 4 part segment on radial nerve palsy. In this podcast, we discuss diagnosis, evaluation, and initial management of patients with radial nerve palsy. We plan episodes on tendon transfer, nerve transfer, and therapy in this population. Note- we apologize for some background noise (kids). Subs…
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Season 3, Episode 45. Chuck and Chris talk about a new HBR article by Bill Taylor, "Your Competitors Aren’t Always Who You Think They Are". We explore what this means in healthcare and how we can optimize the patient experience. https://hbr.org/2022/11/your-competitors-arent-always-who-you-think-they-are Subscribe to our newsletter: https://wustl.u…
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Season 3, Episode 44. Chuck and Chris talk international 'mission' trips with Chuck's trip to St Vincent with the World Pediatric Project just finished. Grateful to supporters including the Touching Hands of the ASSH and Orthopediatrics as well. Hear more on thoughts on what makes a great team and a successful trip. Subscribe to our newsletter: htt…
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Season 3, Episode 43. Chuck and Chris discuss their current strategies in treating Dupuytrens disease. In an update from our previous Charlie Eaton interview , we describe our indications, treatment strategies, and outcomes with various procedures. We focus on open fasciectomy and needle aponeurotomy. Subscribe to our newsletter: https://wustl.us6.…
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Season 3, Episode 42. Chuck and Chris talk about two topics, completely unrelated! First, we discuss an important reader- submitted comment regarding fellowship interviews. And second, we discuss how we handle the common issue of finger injuries and potential amputations. Subscribe to our newsletter: https://wustl.us6.list-manage.com/subscribe?u=c6…
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Season 3, Episode 39. Chuck and Chris talk about Chris' favorite topic, NERVE! Today we discuss the common peroneal nerve. We discusse how patients come to us, how we assess preoperatively including workup, and the surgery- common peroneal nerve decompression. Subscribe to our newsletter: https://wustl.us6.list-manage.com/subscribe?u=c6fe13919f69cb…
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Season 3, Episode 40. Chuck and Chris host a live podcast in Boston during the ASSH Annual meeting. This is our second live podcast and, we hope, a step forward in quality and content after our inaugural effort, the London IFSSH Live Podcast. Still some audio quality opportunities but we are making progress! There was great audience questions and t…
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