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Category: March 2019

There are many reasons why the subspecialty of hand surgery is so special and unique. For this edition of Perspectives, we asked members to tell us how (and where) they feel the field of hand and upper extremity excels where other fields may fall short. Our members agree that hand surgeons are willing to go the extra mile (literally).

Patient Safety Scenario #9: Wrong Equipment

This essay is the ninth installment of the monthly Patient Safety essays, produced by the Patient Safety Subcommittee of the Ethics and Professionalism Committee. The essays are written in the spirit of the aviation industry’s “Black Box Thinking” in order to inform and improve our medical safety record. To read earlier essays and learn how […]

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She…

By Jefferson Braga Silva, MD, PhD She, surgery of the hand, transcends the obvious, reason and purpose. She returns movement and hope to the patient, who would otherwise be paralyzed and segregated from their family and colleagues due to a peripheral nerve injury. She reconstructs segments of a malformed body, returning dignity to the person and improving […]

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A Ripe Field for Innovation

By Nathan Douglass, MD One area where hand surgery has excelled recently where other fields have not is in the area of in-office or wide-awake procedures. There has been increasing interest and popularity in performing wide-awake-local-anesthesia-no-tourniquet (WALANT) cases in the literature and in hand surgery forums (e.g. the ASSH listserv, hand society meetings, etc.). There […]

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Thinkers, Tinkers and Pranksters

By Vincent Fietti, MD The question can be interpreted in various ways.  If one is meaning, are the outcomes in hand surgery better than in other surgical fields, I would say no.  Different, but not necessarily better.  The advances in techniques/instrumentation have largely paralleled across fields. But if the question asks if hand surgery is […]

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Excellent Training

By John Fowler, MD It has been my experience, both in residency and fellowship, and now as a faculty member at an academic institution, that the field of hand surgery excels at allowing our trainees to have significant hands-on experience in both the operating room and office.  Several of my co-residents noted that their fellowship […]

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Working “Hand-in-Hand”

By Julie Chakriya Kvann, MD How does hand surgery excel these days? I think hand surgery excels at working “hand-in-hand” with patients, even in the middle of surgery. Literally.  In this day and age, medicine is more and more patient-focused. Doctors are becoming less paternalistic and patients are becoming more involved, as we realize that […]

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The Most Complex Instrument

By Antonia Russomando, MD I am an Italian hand surgeon, and I’m glad to have the opportunity to share my opinion with colleagues from all over the world about such a stimulating question, to which it is also very difficult to give an unequivocal answer. I started my training in hand surgery when this branch […]

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Ownership of the Hand

By Joseph Said, MD In modern times, many specialties fall short of maintaining continuity of care especially after a complication.  Skin loss, injured nerves, or complex revision arthroplasties are outsourced to another specialty. By contrast, hand surgeons have taken ownership of the hand in its entirety with few exceptions. We are often the primary care […]

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Alternative Incisions

By William Edward Sanders, MD 1) Volar radial wrist incision for DeQuervain’s release Make a short zigzag wrist incision just radial to the radial artery. Undermine beneath the subcutaneous tissue and lift the superficial radial nerve. Release both the abductor pollicis longus and extensor pollicis brevis tendon compartments. A straight incision can be used but […]

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The Importance of Removing Sutures

By Jay Talsania, MD As a surgeon who has been practicing for more than 20 years, I have had a front row seat to both positive and negative changes that have taken place in our evolving medical field. As a community hand surgeon who values many of the recent advances in hand surgery, there is […]

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