Barry Callahan, MD, is a renowned orthopedic hand surgeon at the Alabama Bone & Joint Clinic. He spoke to Becker's on the future of hand surgery and research despite a decreasing investor base.
Dr. Callahan formerly practiced at the Andrews Institute, where he managed collegiate and professional athletes' upper extremity and peripheral nerve conditions.
Q: What would you say is the future of hand surgery?
Dr. Barry Callahan: The future is in technology.
I feel the future of hand surgery is wide open, particularly, in the arena of nerve regeneration/restoration as growth factors and other biologics are harnessed to more accurately control peripheral nerve growth and direction.
My biggest fear, however, is in funding. Businessmen and investors are taking more money out of the system for profit and that results in less funding for our academic centers, which is really where significant advancement of the field occurs.
Q: What kind of research are you conducting on the hand and how are you hoping to improve the field of hand surgery?
BC: I'm currently I'm involved in 2 projects.
The first is a prospective outcome study looking at the incidence of permanent finger PIP flexion contractures in Division I college football. We have interfaced with a number of SEC college athletes and will follow them from before their first season until they leave the program.
Our hypothesis is that a significant number of players sustain volar plate injuries that are basically treated with benign neglect and then are left with a permanent flexion contracture to some extent.
The second project I am working on utilizes new software by a company called Orca. It allows me to send treatment plans to patients by email. Then after the treatment is finished I can obtain a questionnaire from the patient concerning their satisfaction with the visit. It also allows me to include real outcome measurement using PROMIS or any other tool I want to designate; such as the Mayo wrist score for distal radius fracture outcome, for example.
All the physicians in our practice will likely adopt this since pay for performance is going to likely become the standard.
Q: How do you think that robotic prosthetic have changed the field, and do you believe the amount of robotic implants will increase in the coming years?
BC: Robotic prosthetics are improving on an almost daily basis. Similar to the future of the field, interfacing human tissue with a prosthetic is the key to creating a more functional device.
The biggest limitation to these units are they are incredibly expensive. I think our society needs to decide what they feel a functional arm and hand are "worth." Of course, that's easy to do if it's your arm or hand — it'll be anything. It's not so easy to decide for somebody else.
Learn more from Dr. Barry Callahan at the 15th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine in June 2017! Click here for more information.
Editors Note: A previous version of this article stated Dr. Callahan currently practices at the Andrews Institute. He is no longer employed at the Institute.
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