Whats New in Hand Surgery, 2025

Chuck and Chris discuss the new JBJS article, What's New in Hand Surgery, written by Drs Wager and Suh.  Lots of great content in Part 1 on many topics including scaphoid fractures, SL injuries, and nerve compression.

Citations

Wager ER and Su N.  What's New in Hand and Wrist Surgery.  JBJS 2025; 107:543-51

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Transcript

Annual Hand Surgery Literature Review
Chuck and Chris discuss the recent "What's New in Hand and Wrist Surgery" article from JBJS, authored by Eric Wagner and Nina Sue. Charles and Christopher express appreciation for the comprehensive review, noting that it helps them stay current with literature they might have missed. They discuss the value of such annual reviews in keeping up with developments in their field. 

Scaphoid Nonunion

The discussion focused on reconstruction and the ability to restore carpal alignment after osteotomy.  They agreed that the studies cited raise and interesting question and additional investigation might make sense.

Scapholunate Ligament Injuries Treatment Challenges
The discussion focuses on scapholunate ligament injuries and their treatment. Charles and Christopher note that despite various reconstructive techniques being developed over the years, outcomes remain largely unchanged. They discuss a study comparing three common techniques (dorsal capsodesis, Brunelli triligament, and bone-ligament-bone) which showed radiographic deterioration in all cases, though this didn't correlate with functional outcomes. The main goal of treatment is preventing scaphoid flexion to avoid arthrosis. They express skepticism about newer techniques and emphasize the importance of the innovator's expertise in achieving good results. The conversation highlights the ongoing challenges in treating scapholunate injuries effectively.

They also touched on the topic of compressive neuropathy, with Christopher expressing his agreement with Charles' views on the importance of night awakenings as a predictor of surgical improvement after CTR. They briefly discussed the possibility of using ultrasound to predict who would respond to surgery, but concluded that it was not a reliable method. Christopher admitted that he didn't often consider the possibility of amyloidosis in his patients, but Charles suggested that he might start making it part of his practice. They also discussed the possibility of coding for a biopsy and the procedure for taking the biopsy.