The Upper Hand: Chuck & Chris Talk Hand Surgery JHS Journal Club, Part 2: Age and Nerves, Epitendinous Repair, and Weight bearing CT / SLIL
6 snips
Mar 8, 2026 A quarterly journal club dissects recent hand surgery research on age-related nerve regeneration, biomechanical tweaks in epitendinous tendon repair, and weight-bearing CT changes in scapholunate ligament injury. They debate imaging positions, suture caliber and pass strategies, and how aging affects nerve recovery and timing of interventions.
AI Snips
Chapters
Transcript
Episode notes
Use 5-0 Prolene And More Epitendinous Passes
- Use a thicker epitendinous suture and more passes to increase repair strength.
- Cardenas et al. cadaver study showed 5-0 Prolene and eight passes improved tensile strength and 2 mm gap resistance versus 6-0 and fewer passes.
Epitendinous Use Has Fallen Despite Strength Benefits
- Epitendinous sutures often add meaningful strength but practices vary widely.
- Chris Dy and Charles Goldfarb suspect fewer than half of flexor repairs routinely include an epitendinous component today.
Strive For Circumferential Epitendinous Without Bulk
- Aim for near-circumferential epitendinous repair but avoid excessive bulk that impairs glide.
- Both hosts favor locking or simple-then-lock techniques with 2 mm bite from tendon edge and avoid breaking the fine stitch when tying.