Automating your Hand Practice

Incorporating efficient automation into your hand surgery practice can greatly improve office workflow, patient follow-up, online reviews, and increase referrals and patient volume.  The following presentations summarize how you can implement these tools in your practice for little or no cost at all.  Many of these features have also been incorporated into a product solution through www.SurgiSurvey.com.  Please reach out if you would like to learn more.   AAOS 2019: Optimizing Your Practice Website and Online Marketing - Franko - Wed 1030AM AAOS 2019: Revolutionize Your Life With Automation - Franko Thursday 930 ASSH 2018: Automating Your Life - ASSH 2018 - IC72 Building an Efficient Practice ASSH 2018: IC75 - Website Enhancements and Rating Sites to Increase Search Results - 645 saturday...
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Wide-Awake REGIONAL Anesthesia – Surgeon Administered

Wide-Awake REGIONAL Anesthesia – Surgeon Administered

Over the last 10 years, the concept of "WALANT" has greatly reduced the importance of sedation and general anesthesia for hand surgery.  Many surgeons have transitioned towards performing wide-awake, local-only anesthesia with or without a tourniquet.  In many cases, this has allowed for a reduction in cost by transitioning procedures to the office setting, a reduction in cost by avoiding surgery center facility fees, and reducing the patient complications and inconvenience of sedation. However, WALANT technique is most commonly used for "smaller" hand cases: carpal tunnel, trigger fingers, tendon surgery in palm or fingers, etc.  Although some surgeons have utilized WALANT technique for distal radius fractures and other forearm or elbow injuries, this is not widely practice.  Rather, most surgeons perform upper extremity fracture fixation under regional anesthesia with sedation or general anesthesia. Manu member Dr. Orrin Franko has been utilizing surgeon-administered, axillary regional anesthesia, taught to him by his partner Dr. Andrew Stein, since starting practice 3.5 years ago.  Dr. Stein has...
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“Pin Under Plate” Technique for Distal Radius Fractures

“Pin Under Plate” Technique for Distal Radius Fractures

"Pin Under Plate" Technique for Distal Radius Fractures By Dr. Orrin Franko Distal radius fractures are quite fun to treat, often because of the great variety of "tips and tricks" available to surgeons in the procedure.  Personally, one of my favorite tricks us to use 0.35 K-wires held beneath a volar plate to capture and provide stability to small or challenging fragments that would otherwise be difficult to stabilize with a screw.  I cannot take credit for this technique, rather it has been published by Dennison & Moore in 2014 in a small series.  However, my preferred technique varies somewhat from their recommendation based on experience with over 30 fractures.  I have highlighted my tips and tricks below, with example images. The concept is simple: fracture fragments that are either too small or too distal to be securely fixed with a traditional locking screw can be stabilized with a K-wire.  That k-wire can be subsequently secured beneath a traditional plate.  Together, a rigid construct...
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