The Upper Hand: Chuck & Chris Talk Hand Surgery Pearls and Challenges: Carpal tunnel, practice efficiencies, and the ulnar wrist
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Aug 31, 2025 Dive into the complexities of treating the ulnar wrist and managing carpal tunnel with practical pearls shared by listeners. Discover effective techniques for ECU tendonitis and wrist assessments, along with the importance of thorough patient preparation and surgical scheduling. The hosts share a humorous take on unexpected alarms and highlight community feedback that shapes their conversations. Tune in for surgical insights and tips, including innovative uses of tools for better outcomes.
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Use A Nasal Speculum For Retraction
- Try a nasal speculum as a one-handed near-circumferential retractor for proximal carpal tunnel release.
- It can replace the three-retractor box and is commonly available in centers with ENT tools.
Prefer A Small Weitlaner And Body Weight
- Use a small Weitlaner (3-2) or blunt retractor to spread tissue during solo carpal tunnel release.
- Lean your forearm weight onto the retractor to keep the palm flat and avoid slipping into Guyon's canal.
Ragnells Are Best For Trigger Releases
- For trigger finger releases, use Ragnell retractors on each side of the sheath and a blunt Senn distally to expose the A1 pulley.
- In pediatric trigger thumbs, use three Ragnells when needed because a Senn may not reach the right spot.