Hand Surgery Journal Club
Last Updated September 18, 2013
The Schedule for the Year 2013
The meeting date is the third Tuesday of the month and the time is 7:00 pm for food and cases. Noah has observed that we either have to start the Journal (ie, end cases) by 8:30 pm or change the name to Cases Club. Late-comers will be requested to save their cases until after Journal Club. If you cannot attend, please email the host at least a day in advance, as this helps them to plan the food. If less than 24 hrs, please call.
| DATE |
HOST |
PROPOSED |
ACTUAL |
Dec 18 |
Mat |
Oct (Start in Back) |
killed |
| Jan 15 |
Monty |
Nov |
dead |
| Feb 19 |
Charlotte |
Dec 2012 |
over |
| Mar 19 |
Doug |
Jan 2013 |
- |
| Apr 16 |
no meeting |
- |
- |
| May 21 |
Kendrick's BBQ |
Feb
|
overrun |
| June 18 |
Bob |
April (skip March) |
pretty well covered |
| July 16 |
Hillary |
May |
mangled |
| Aug 20 |
Relton |
June |
chopped to bits |
Sept 17 |
Becky |
July |
trodden through |
| Oct 15 |
Mat |
August |
- |
| Nov 19 |
Josh |
- |
- |
Dec 17 |
Bill |
Oct |
done |
Jan 21 |
Doug will host at Loring Cafe, 37 Grand Ave, Oakland. Doug's cell is 925 549 2446. Issue is November |
Nov |
- |
September was Becky's month and she did it in style. Present were: Bill, Mat, Relton, Kendrick, Bob, Hillary (whose name was omittted from the announcement; use Reply All to this email and it should get to everyone in the future), Monty made a brief appearance and then family responsibilities called him away, but his absence was offset by Doug's late appearance. Rebecca and the JN rounded out the table. Wine, salame, and cheese started out the night, then we moved to the Lazy Susan to have salad, melon with proscuitto, garlic bread and fresh figs. The final course was a nice al dente pasta. Becky made a special peach cobbler which she served with ice cream. Coffee flowed as the cases were presented. The Journal discussion again demonstrated that we all have our own ways of approaching problems. The diversity of surgical choice is strongly defended but weakly substantiated, but weak substantiation has never decreased the strength of defense: I prefer Tegaderm for fingertip amputations, Kendrick likes xeroform, and Doug likes flaps, but there are no prospective studies). Notable papers include:
(1) night splinting in Duputyren's may not be useful; several said that they never did, several always did, may change
(2) the Thompson procedure (named here for the first author, but commonly called a Littler, for the senior author, JHS, 1978, 482) SORL reconstruction for mallets that progress to swan necks was discussed. The same end can be achieved with a FDS tenodesis; only Relton had done a Littler but it worked great for him. The illustrations by Littler deserve repeating:
Swan neck deformity
Demonstration of dynamic tenodesis
Littler's technique
The rest of the papers did not generate much enthusiasm. Is there one that you would like to discuss?
Josh is up next, with August. How about a map, Josh?
The August meeting was hosted by Relton, in style. The turnout was modest but an intellectual quorum was reached, with Kendrick, Bill, Josh, Bob, and David present. Collegiality was found in abundance, as usual. After the cheese appetizer of Brie, Manchego, Fontina and St. Agur blue, dinner was grilled tenderloin of beef encrusted in thyme and parsley (served with chimichuri sauce) with mashed potatoes and French fillet beans from the garden (the green ones were Nickel, the yellow ones were Soleil). Barb's home-grown apples, half Gravenstein and half Macintosh, were made into a divine pie, good enough to wean even Nelson from chocolate. The coffee was from Peets. All the wines were from Kermit Lynch; one of Bill and Kendrick's favorites stores.
July was hosted by Hillary and her husband, David, with a grandeur and style that was stupendous. Present were Bill, Bob, Monty, Rebecca, Mat, Relton, Noah, Kendrick, and David. Hillary raided her wine cellar and brought out more bottles than even our motley crew could drink, and matched it with cheese and crackers. The dinner was lamb chops and jumbo shrimp (a great oxymoron, second only to military intelligence), grilled to perfection by Hillary, and served with home-grown tomatoes as well as home-grown rosemary, basil, and more. She kept up the tradition with a chocolate bunt cake and ice cream (Monty deserves special mention for giving me two scoops).
We visited some cases, the most notable of which was a beautifully documented midcarpal instability case of Noah’s, who showed us the dramatic fluoroscopic video of the catch-up clunk. There was a consensus that the precise cause is unknown, the best treatment is unknown, but this did not slow the flow of recommendations. Brunelli-style reconstruction to keep the scaphoid (and proximal row) in extension (Relton) competed with dorsal capsulodesis to keep the lunate in extension (Bill), but all agreed that we don’t understand this yet.
David presented a case of a distal radius fracture (anyone surprised?) that got cancelled on the table after the patient was asleep because of this (everyone surprised?): fracture blisters.
We then proceeded to the Journal. The discussion was lively but the pleasure was barely due to the quality of the articles, but more due to the additional cases and topics brought up. The JN had to do his nasty job several times (anyone who wants the job can have it), tried not to be rude, but given the size of the group, multiple conversations stops the progress of the evening and we don’t get through the issue. Bob kept nudging me to crack to the whip, so the whip got cracked. My apologies to all. We did not make it to the Review Articles, which often are the best part of the Journal. We need to discuss how to get farther in the issue. For everyone’s information, the link to J Club is: http://www.davidlnelson.md/JClub.htm Please bookmark this, as there is no link on my site anymore, due to programming errors done by the person I hired to update the site. Relton has the next meeting, and we are doing June, in keeping with the dictum that we will read the issue 2 months out.
June Bob did us proud, with marinated barbequed flank steak, and lots of it! Present were Bill, Hillary, Charlotte (a surprise, since we though May would be her last time with us), Kendrick, Relton, Becky, David and Bob. (I am writing this several weeks late, so if I missed anyone, please let me know.) There was a wonderful selection of cheeses and crackers, that were discussed and sampled. Wines came out of the cellar, including one with a least an inch of dust testifying to its age. The steak was accompanied by salad and bread. There was one dish that did not make it to me, but I was so busy eating I did not mind. Bob? We did a few cases then on to the Journal. We skipped over some rabbit and chicken studies, as well as one by a local surgeon who owns the intellectual property rights to a tendon repair device. Several people liked the idea of scaphoid humbacks being treated with cancellous, not structural cortical, bone graft. I enjoyed the comparison of surgical exposures to the radius, learned that the interval between the radial artery and the FCR was Orbay's idea, and that the original Henry approach was between BR and the radial artery. Several mentioned that Henry's book was the best poetry in the hand literature. A great time was had, with comraderie and scholarship all around. Charlotte got hugs from all, she will be missed, but we promised to visit in Chicago.
May Kendrick did his usual May BBQ and it was wonderful. Present were Bob, Josh, Rebecca, Charlotte (possibly her swan song., moving to Chicago), Johnny, Monty, Noah, David, and Kendrick (as well as both of his kids, who we have not seen in ages, and Ruth). Kendrick's entire family got involved in the BBQ. We were served Korean BBQed shortribs and chicken, rice, spinch, squash, and sprouts. Wine was an Austrian gruner veltliner, and two Rhinegau rieslings. Beers were OB lager (Korean), Sierra Nevada summerfest, and Anchor American Wheat lager. Appetizers were green onion pancake (pajeon), and fried shisito peppers (Japanese analog to padron peppers). A few cases were presented, including Rebecca's Essex-Lopresti forearm. We discussed our treatment of resistant lateral epicondylitis, and then the group proceeded to the Journal. We found little that was memorable (there was at least ONE article on distal radius: don't fill both rows automatically, but certainly place a screw if a fragment needs it), but it still took most of the evening to get near the review articles, but we still did not get to them. There was a motion to keep to a schedule of covering the Journal for two months prior, no matter what was covered before. Therefore, at Bob's house in June, we will be doing April. David mentioned that Michelle James, MD, is speaking Friday for the SF Bay Area Hand Club.
January Monty hosted the January Journal Club and we had a great turnout. Present were Bob, Kendrick, Josh, Rebecca, Mat, Charlotte, Bill, Relton, Hillary, and David. While there was a great turnout, we were not at all crowded and had a great time. We all feasted on great Indian cuisine, including various curries and naan, accompanied by wine. Monty has come under the bad influence of Kendrick and gave a case report of a revision de Quervain’s surgery (Kendrick did the original), with the finding of multiple slips of the AbPL with an insertion on the triquetrum; however, with only about an hour or so of followup, he had no idea of whether the surgery solved the problem or not; he was encouraged to give us some further followup. Kendrick mentioned a paper that Mark Nissenbaum had written but not published, that persistent de Queravain’s may be due to triquetral insertions of the AbPL. If Monty’s surgery is curative, this really needs to be published.
The final Journal Club of 2012 was hosted with style by Mat and Nancy. Attending were Kendrick, Charlotte, Becky, Noah, Relton, Hillary, and David. We started with smoked salmon, shrimp, cheese, and wine. The main course was baked salmon and stuffed pasta (to call it ravioli does not seem right). Noah presented three cases with xrays, Kendrick one sans radiographs, and we moved to the Journal. Most of us brought the October 2012 Journal, a few brought November 2012, but one creative member who will remain nameless brought October 2011, which had actually already been covered. The rest of us opened our copies of October 2012. We started in the back, with Scott Wolfe's summary of SL instability, and worked forward. Despite the low turnout, the miscellaneous conversations resulted in a noise level that made progress slow. We need to think about simultaneous conversations and their effect on the flow of the night. We covered a good part of the Journal and retired at 10.
A few people volunteered for the 2013 year. Please check your calendars and sign up.
Noah has promised to pick a date for the Napa/Sonoma meeting of Journal Club, giving members plenty of lead time to arrange their schedules for the year. The Wine version of Journal Club is one of the most memorable occasions of the year (see: http://www.davidlnelson.md/BuenaVista2.htm), as all who have been on one can attest. We have have not had one for several years due to low turnout. If we are to have another, members must commit to scheduling all their vacations, and if necessary, their children's birthdays and their anniversaries, at another time <g>. Noah goes to a lot of work to schedule these and pulls a lot of favors, so we need to support him by attending. All suggestions on this matter are welcome.
Other Meetings of Note
|
AAOS 80th Annual Meeting |
|
May 24 Michelle James, MD November 8 at Stanford |
