The Upper Hand: Chuck & Chris Talk Hand Surgery What's New in Hand Surgery, 2025 Part 2
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Apr 27, 2025 Two hand surgeons share a light-hearted reunion while delving into fascinating surgical advancements. They explore the complexities of ulnar nerve decompression and the decision-making in cubital tunnel syndrome treatment. Key discussions include innovations in joint arthroplasty, comparing silicone and pyrocarbon implants. The podcast also highlights the evolving role of wrist arthroscopy and challenges in nerve surgery, making for an insightful blend of humor and valuable medical knowledge.
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Failed Cubital Tunnel Decompression Cases
- Chris Dy has treated five patients recently who experienced failed cubital tunnel decompressions with persistent symptoms.
- All cases involved long incisions and unclear preoperative workups, raising questions about initial treatment effectiveness.
Debate Over Cubital Tunnel Procedures
- Literature suggests no significant difference in outcomes between ulnar nerve decompression and transposition.
- But there is bias, and transposition involves more work, which is not reflected in coding or compensation.
Revision Technique for Ulnar Nerve Surgery
- Be proficient in both subcutaneous and submuscular transposition techniques for ulnar nerve revision surgery.
- Submuscular transposition is often preferred for revisions due to more reliable symptom improvement.