The Upper Hand: Chuck & Chris Talk Hand Surgery Whats New in Hand Surgery, 2025
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Apr 13, 2025 Dive into the exciting world of hand surgery as the hosts discuss recent advancements, including treatment strategies for scaphoid fractures and the debate on optimal bone healing. They explore the innovative Checkpoint Guardian Nerve Stimulator's role in orthopedic procedures and unpack the complexities of compressive neuropathies. Discover key insights into carpal tunnel syndrome, from critical symptoms to rapid recovery tips. Plus, enjoy anecdotes from recent travels and the importance of collaboration in this evolving field!
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Healing vs Alignment in Scaphoid Fractures
- Healing the scaphoid bone and correcting carpal alignment are both important, but sustained alignment correction is achieved in only about half of patients.
- Clinical experience suggests that bone healing is more critical than perfect alignment to prevent problems like scapholunate advanced collapse (SNAC) wrist.
Use Ultrasound with Caution
- Low intensity pulsed ultrasound (LIPUS) is commonly used despite lacking strong evidence for healing scaphoid fractures.
- If insurance covers it, support its use, but be transparent about the limited scientific support.
Handle Complex Scaphoids Appropriately
- Do what works best in your hands or refer complex scaphoid cases needing vascularized grafts to experts.
- Using dorsal or volar approaches for graft is fine; call in a specialist if vascularized graft is necessary.