The Upper Hand: Chuck & Chris Talk Hand Surgery Technical Considerations in the treatment of Kienbocks
Jan 7, 2024
The hosts dive deep into Kienbock's disease, exploring patient evaluation and surgical strategies. They discuss unique approaches like radius shortening and vascularized bone flaps. The conversation includes the challenges of diagnostic imaging and treatment efficacy. Surgical confidence is highlighted as crucial for successful outcomes, along with the importance of patient engagement during recovery. Their reflections on personal journeys and podcast milestones serve as an engaging backdrop to the technical insights.
AI Snips
Chapters
Transcript
Episode notes
Cast Before Surgery for Kienbocks
- Casting is a good initial treatment for Kienbocks patients without carpal collapse.
- Exhaust non-operative options but don't delay surgery if pain persists after casting.
Ulnar Variance Guides Surgery Choice
- Ulnar variance is the key radiographic factor guiding Kienbocks surgery.
- Radius shortening suits patients with negative ulnar variance to offload the lunate effectively.
Denervation as a Surgical Bridge
- Partial wrist denervation could buy time for patients not ready for bigger surgery.
- It's better as a bridge, often coupled with other procedures, not a definitive cure for Kienbocks.