The Upper Hand: Chuck & Chris Talk Hand Surgery
Chuck and Chris host Podcast Journal Club
Oct 1, 2023
Chuck and Chris discuss studies on thumb CMC arthritis treatment, endoscopic vs. open carpal tunnel release surgeries, and conduits vs. decellularized nerve allografts for digital nerve repairs. They share concerns about over-distracting in arthritis treatment and discuss the implications of higher revision rates in endoscopic surgeries. They also emphasize the importance of honest reporting in medical studies.
30:11
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Quick takeaways
- Allografts yield better outcomes in long gap digital nerve repairs compared to conduits.
- Revision rates are higher in endoscopic carpal tunnel release procedures, raising questions about their effectiveness and safety.
Deep dives
Conduits versus Allografts for Digital Nerve Repairs
A study compared the outcomes of using conduits and allografts for digital nerve repairs in both short and long gap repairs. In short gap repairs (5-14mm), there was no significant difference in outcomes between the conduit and allograft groups. However, in long gap repairs (15-25mm), the allograft group showed clinically superior results compared to the conduit group. The allograft provided better outcomes in terms of normal sensation, with 40% achieving normal sensation compared to 18% in the conduit group. The cost difference and ease of availability between conduits and allografts may influence decisions regarding which option to use for short gap repairs.
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