The Upper Hand: Chuck & Chris Talk Hand Surgery

Chuck and Chris briefly review challenges with the US healthcare system but spend most of the episode discussing difficult hand fracture cases. Meyer ZI, Goldfarb CA, Calfee RP, Wall LB. The Central Slip Fracture: Results of Operative Treatment of Volar Fracture Subluxations/Dislocations of the Proximal Interphalangeal Joint. J Hand Surg Am. 2017 Jul;42(7):572.e1-572.e6. doi: 10.1016/j.jhsa.2017.03.030. Epub 2017 May 3. PMID: 28476538; PMCID: PMC5510930. See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris share thoughts and tips for success for new attendings and new fellows. Things such as the 3 A's and the 3 E's (tune in for this new one) and many other pearls. See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris review 6 recent Journal of Hand Surgery articles with a variety of topics. Tune in and see below. 1) Arends GR, van Kooij YE, Stern BZ, Hovius SER, Wouters RM; Hand-Wrist Study Group; de Ridder WA. Understanding Why Certain Patients With Hand and Wrist Conditions Are Dissatisfied Despite Achieving Their Expressed Personal Improvement Goals Anchored at Satisfaction: A Qualitative Study. J Hand Surg Am. 2026 Jun;51(6):687-697. doi: 10.1016/j.jhsa.2025.12.009. Epub 2026 Jan 29. PMID: 41609542. 2) Lee SH, Kim MB, Lee YH. Surgical Management of Delayed Mallet Finger Fractures Using Combined Two-Extension Block Kirschner Wire and Dorsal Counterforce Techniques. J Hand Surg Am. 2026 May;51(5):555-563. doi: 10.1016/j.jhsa.2025.12.019. Epub 2026 Jan 29. PMID: 41609545. 3) Lunasin RM, Capell W, Kaufman KR, Shin AY. Rethinking Muscle Testing: Dynamic EMG Studies of Elbow Positioning as a Differentiator of Pronator Teres and Quadratus Functions. J Hand Surg Am. 2026 Apr;51(4):437.e1-437.e8. doi: 10.1016/j.jhsa.2025.09.013. Epub 2025 Oct 29. PMID: 41159989. 4) Morisaki S, Yoshii K, Tsuchida S, Oda R, Takahashi K. Comparison of Manual Tie and Knotless Suture Anchor Techniques in Arthroscopic Transosseous Foveal Repair of the Triangular Fibrocartilage Complex. J Hand Surg Am. 2026 May;51(5):503-510. doi: 10.1016/j.jhsa.2026.01.021. Epub 2026 Mar 4. PMID: 41778936. 5) Mwangi J, Henriquez AR, Varney CR, Yu R, Kim JK, Baker RL Jr, Pidgeon T, Hammert WC. Suture-Button Suspensionplasty Does Not Provide a Sustained Functional Advantage Over Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis. J Hand Surg Am. 2026 Jun;51(6):623-630. doi: 10.1016/j.jhsa.2026.02.019. Epub 2026 Apr 3. PMID: 41934451. 6) Surke C, Del Rosario PA, Huntington LS, Ek ETH, Tham SK, Ackland D. Fracture Fixation in an Unstable Scaphoid Fracture Model: A Biomechanical Comparison of Double Screw Osteosynthesis With Two Common Bone Graft and Fixation Techniques. J Hand Surg Am. 2026 Apr;51(4):391.e1-391.e8. doi: 10.1016/j.jhsa.2025.09.007. Epub 2025 Oct 25. PMID: 41137815. See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris have a potpourri of topics including CMS proposed changes for 2027 (not good for hand surgery), cases, and two listener submitted topics: board preparation and caring for patients with ligamentous laxity/ Ehlers Danlos. Chuck references Christian Pean's Substack called 'Techy Surgeon' as a great resource for value based care and all things tech including AI insights. See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris welcome Kathleen McKeon as our guest to discuss practice types, including: academic private PE-backed private an employed positions Dr. McKeon has personal experience with PE and shares insights for us all to consider. We also learn a bit about her personal journey joining a well-known sports practice and succeeding in a "privatademic" environment. Dr. McKeon references Ben Schwartz' Substack called 'The Surgeon's Record' as a great resource. See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris welcome Mark Baratz as our guest to talk about a number of topics, including sustainability and surgery, book club, culture, and so much more. Join us for pearls of wisdom from Mark Baratz and learn alongside of us. See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris catch up and discuss the new JBJS 'What's New in Hand Surgery', written by Eric Wagner and Nina Suh. This takes us through 2025 and highlights new and impactful scientific articles on our field. Wagner ER, Suh N. What's New in Hand and Wrist Surgery. J Bone Joint Surg Am. 2026 Mar 18;108(6):401-409. doi: 10.2106/JBJS.25.01568. Epub 2026 Feb 3. PMID: 41632853. We are still need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris catch up and discuss a few clinical scenarios including the Arcade of Struthers and indications to address it with ulnar nerve transposition. They also discuss adolescent forearm instability, especially in congenital conditions, and the role of the one- bone forearm We are still need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris continue the initiative working with The Journal of Hand Surgery on a quarterly journal club. Nash and Macerena choose the articles from the previous quarter and Chris and Chuck review the articles and discuss practical implications. See articles below. In addition, we discuss a case of possible pronator syndrome together with carpal tunnel syndrome including debate on the role of nerve studies, physical examination, and ultrasound. 1) Rames JD, Emanuels AF, Tunaboylu MF, Moran SL. A 40-Year Retrospective Evaluation of Vascularized Bone Grafting for Kienböck Disease. J Hand Surg Am. 2026 Jan;51(1):13.e1-13.e9. doi: 10.1016/j.jhsa.2025.07.025. Epub 2025 Aug 29. PMID: 40879579. 2) Suzuki T, Kiyota Y, Matsumura N, Sato K, Nakamura M, Iwamoto T. Anatomical Reconstruction of the Terminal Tendon and Lateral Band for Severe Chronic Tendon Mallet Injury. J Hand Surg Am. 2026 Jan;51(1):92.e1-92.e7. doi: 10.1016/j.jhsa.2025.04.025. Epub 2025 Jun 21. PMID: 40542795. 3) Lee C, Shin S, Fraipont G, Hung V, McGarry MH, Lee TQ. Dermal Allograft Augmentation With Proximal Row Carpectomy: A Biomechanical Study. J Hand Surg Am. 2026 Feb;51(2):143-152. doi: 10.1016/j.jhsa.2025.05.006. Epub 2025 Jul 4. PMID: 40613810. 4) Jaarsma EH, Ring D, Tonn MD, Brinkman N. Do Patients Older Than 40 Years with Work Claims for Unilateral Wrist Symptoms Have Symmetric, Bilateral MRI Signal Changes That Do Not Correspond with Symptoms? J Hand Surg Am. 2026 Mar;51(3):313-320. doi: 10.1016/j.jhsa.2025.11.012. Epub 2026 Jan 29. PMID: 41609546. 5) Pohl NB, Brush PL, Parson JP, Fitzgerald P, Charlton A, Beredjiklian PK, Fletcher DJ. Incidence and Predictors of Subsequent Triggering Requiring Treatment After Trigger Finger Release. J Hand Surg Am. 2026 Feb;51(2):203.e1-203.e8. doi: 10.1016/j.jhsa.2025.02.009. Epub 2025 Apr 9. PMID: 40202483. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris catch up on recent travels including the Pediatric Hand Study Group meeting in Atlanta. We discuss a few cases including a 5th CMC fracture dislocation, a 5+ year old scaphoid nonunion, a nightstick fracture, and more. We also respond to listener submitted questions including 4th compartment tenosynovitis, CMC arthritis with MCP hyperextension including the role of CMC fusion, and ulnar nerve transposition. We are still in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris welcome Jason Strelzow to discuss AI in general, applications in medicine (including ambient listening), and his favorite chatbot. Dr. Strelzow is a hand surgeon with a trauma focus at Wash U and is the JBJS AI Associate Editor. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris spent a few minutes discussing Artemis II. So many interesting discussion points from this mission around the moon- we focus on selection criteria for competitive jobs (like astronauts and orthopedic residents)! In addition, we hit the highlights from Rick Wright's visit as a Leadership lecturer. Rick spoke on 'How to be the best resident and attending' and we all learned a great deal. Chris and Chuck break this down. The Artemis II Effect: When Everyone Is Brilliant, Character Becomes The Mission. Penny Abeywardena , Forbes Magazine April 9th. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris discuss volar plating for distal radius fractures. What are the alternatives, what are some technical pearls, and more. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris share interesting information about Chuck's trip to India for the World Congenital Symposium and Chris' visit to the Curtis National Hand Center as a Visiting Professor. Then they discuss a listener's concern about their discussion of operating room efficiency/ Chuck's trip to Atlanta. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris begin a new initiative working with The Journal of Hand Surgery on a quarterly journal club. Nash and Macerena will choose the articles from the previous quarter and Chris and Chuck will review the articles and discuss practical implications. This first episode includes discussion of the following articles from Q4 of 2025: Porche KM, Spinner RJ, Bishop AT, Pulos N, Shin AY. Age-Related Effects on Peripheral Nerve Regeneration. J Hand Surg Am. 2025 Dec;50(12):1498-1504. PMID: 40817901. Cardenas D, Dogaroiu A, Harirah M, Zhang AY, Odobescu A, Sammer DM. Biomechanical Comparison of Suture Caliber and Number of Passes in Epitendinous Repair. J Hand Surg Am. 2025 Oct;50(10):1278.e1-1278.e6. PMID: 39903150. Ritchie B, Saini J, Mack ZE, Munn A, Dhaliwal G, Roach KE, Manske SL, White NJ. Weight-Bearing Computed Tomography Analysis of Scapholunate Ligament Injury. J Hand Surg Am. 2025 Nov;50(11):1304-1312. PMID: 40944679. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris begin a new initiative working with The Journal of Hand Surgery on a quarterly journal club. Nash and Macerena will choose the articles from the previous quarter and Chris and Chuck will review the articles and discuss practical implications. This first episode includes discussion of the following articles from Q4 of 2025: Portney DA, Lee CP, Wolf JM, Strelzow JA, Stepan JG. A Changing Landscape in Surgical Treatment of Basilar Thumb Arthritis: Is the Rate of Denervation Increasing? J Hand Surg Am. 2025 Oct;50(10):1280.e1-1280.e8. PMID: 39918526. Earp BE, Zhang D, Benavent KA, Ostergaard PJ, Blazar PE. The Use of Telemedicine Postoperative Visits Following Carpal Tunnel and Trigger Digit Releases: A Randomized Clinical Trial. J Hand Surg Am. 2025 Dec;50(12):1431-1437. PMID: 41117725. Amen TB, Ibrahim LI, Gillinov SM, Torabian KA, Dean MC, Liimakka A, Lee SK. Glucagon-like peptide-1 Agonists and Common Hand Procedures: Perioperative and Postoperative Risks and Complications. J Hand Surg Am. 2025 Nov;50(11):1297-1303. PMID: 41055617. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris review common, "straightforward" surgeries in hand surgery and what might go wrong. We specifically discuss trigger finger release, dequervains release, ganglion excision and carpal tunnel release. We share our thoughts and hope for listener feedback. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris respond to listener submitted questions regarding cubital tunnel decompression and ulnar nerve transposition. We also discuss some nuanced cases of thumb UCL injuries. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chris goes solo on this one as we share his guest podcast appearance on "The Resident Review Podcast." The Second Look: Navigating Revision Surgery for Carpal and Cubital Tunnel Syndromes Revision surgery for nerve compression in the upper extremity presents unique challenges. While primary decompression procedures for conditions like Carpal Tunnel Syndrome (CTS) and Cubital Tunnel Syndrome (CuTS) are common, addressing persistent or recurrent symptoms requires a specialized approach. Dr. Dy provides an in-depth look at the workup and surgical philosophy for these complex revision cases. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Chuck and Chris discuss tricks and tips for elbow arthroscopy, a listener submitted topic. Learn more about indications, portal placement, and keys to success. We are in need of a podcast intern! We would appreciate any referrals! See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities. The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/. As always, thanks to @iampetermartin for the amazing introduction and concluding music. For additional links, the catalog. Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx