Meeting the Challenge of the New Decade
Print Friendly Print     Email this page Email    

Instructional Courses Thursday

September 6, 4:30 - 6:30 PM

Location varies, refer to session details below.

CME Available: The ASSH designates this live activity for a maximum of 1.50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

IC01: Dupuytren’s Contracture - MOC Approved Course

Moderator: Donald H. Lalonde, MD
Location: Regency B, Hyatt Regency Convention Center

Description:

This is an ABPS MOC approved course.  The current status of MOC requirements for ABPS and ABOS will be outlined.  The course will fulfill some of the requirements for part II and part IV for the ABPS Dupuytren’s practice improvement module.  The best current literature evidence in managing Dupuytren’s contracture with surgery, needle aponeurotomy and enzymes will be reviewed.  Pearls and pitfalls of surgery, needle aponeurotomy and enzyme injection will be shown with film and discussed.  Ample time will be spent reviewing the risks and benefits of the three treaments, as well as how the discussants decide which treatment they will use and when. The wide awake approach to Dupuytren’s surgery will be explained with film.  This technique allows unsedated, tourniquet-free, comfortable patients to actively move and see movement of the fingers at the end of surgery without any of the risks and inconveniences of general anesthesia.  This course is aimed at board certified diplomates who have experience in Dupuytren’s surgery and who want to improve their practice.  The course providers intend to  get straight to the important areas of discussion and bypass intro level material.  They want participants to leave feeling that they have learned the best that providers have to offer that may be new, practical or useful to improve their practice.  ASSH will provide multiple choice questions online before the course to those who register, as well as the same post-test after the course to see how participants improve their scores.

 

Learning Objectives:

  • Contrast the relative risks and benefits of surgery, needle aponeurotomy and enzymes.
  • Justify the choice of management of surgery, needle aponeurotomy and enzymes.
  • Analyse when to use the different treatments of Dupuytren’s.
  • Describe how to perform needle aponeurotomy and enzyme injection for Dupuytren’s.
  • Identify pearls and avoid pitfalls in the management of Dupuytren’s.

Faculty:

A. Lee Osterman, MD
Charles J. Eaton, MD
John G. Seiler, III, MD
View faculty disclosures here.

 

IC02: Thumb Basilar Joint Arthritis: From the Primary Case to the Management of Failed Joint Arthroplasty

Moderator: Sanjeev Kakar, MD, MRCS
Location: Columbus EF, Hyatt Regency Convention Center 

Description:

The purpose of this Instructional Course Lecture is to present the audience with an overview of the pathophysiology of basilar thumb joint arthritis and review the treatment options/available evidence including arthroscopic debridement, trapeziectomy with suspension arthroplasty and joint replacement.  Areas of controversy, such as whether and how to address MCP joint hyperextension and also the management of failed primary basilar thumb joint reconstructions, will be covered and an algorthim presented.  The faculty will present various cases for panel and audience discussion.

 

Learning Objectives:

  • Have an understanding of the pathology of basilar thumb joint arthritis and the development of z deformity of the thumb.
  • Delineate the various treatment options for primary basilar joint arthritis and their indications and contraindications.
  • Have an algorithm for the management of failed primary surgery and have revision options within their armamentarium.

Faculty:

A. Lee Osterman, MD
Steven L. Moran, MD
Richard A. Berger, MD, PhD
Jeffrey Yao, MD

View faculty disclosures here

 

IC03: PIP Joint Fracture Dislocations: Evaluation and Treatment Options

Moderator: Julie E. Adams, MD
Location: Regency D, Hyatt Regency Convention Center 

Description:

Proximal interphalangeal (PIP) joint injuries can be difficult to treat.  Options for the dorsal fracture dislocation include splinting, internal fixation, external fixation, volar plate arthroplasty and hemihamate arthroplasty.  Challenges of evaluation and treatment include discerning which treatment option is most appropriate in a given situation.   In this instructional course lecture, strategies for evaluation and treatment are discussed.  Individual treatment options will be discussed with an emphasis on indications, contraindications, postoperative rehabilitation, complications and anticipated outcomes.  Cases and interactive discussion will highlight tips and techniques and allow audience participation. 

Learning Objectives:

  • Understand principles for evaluation and treatment of PIP joint fracture dislocations.
  • Understand indications for nonoperative treatment of PIP joint injuries.
  • Evaluate and chose between treatment options for PIP fracture dislocations.
  • Understand postoperative management and complications associated with PIP joint injuries.

Faculty:

Robert J. Strauch, MD
O. Alton Barron, MD
Ryan P. Calfee, MD

View faculty disclosures here

 

IC04: Optimizing Hand Therapy Following Complex Trauma

Moderator: Christine B. Novak, PT, PhD
Location: Buckingham, Hyatt Regency Convention Center

Description:

Management of patients following complex trauma for tendon, nerve and bony injury can be challenging, and optimal outcomes necessitate a collaborative relationship between the patient, surgeon and hand therapist. Through didactic presentations and case discussion, this course will focus on the key elements of patient management from a biomedical and psychosocial approach. Practical pearls and pitfalls of hand therapy to maximize outcome will be presented.

Learning Objectives:

  • Understand acute fracture, nerve and tendon management in complex trauma.
  • Discuss the postoperative protocols following complex traumatic upper extremity injury.
  • Review the biomedical and psychosocial factors related to outcome following traumatic upper extremity injury.

Faculty:

Michael W. Neumeister, MD
Kristen A. Valdes, OTR, CHT
Rebecca von der Heyde, PhD, OT, CHT

View faculty disclosures here

IC05: Reconstruction in Mutilating Hand Injuries

Moderator: Kagan Ozer, MD
Location: Columbus CD, Hyatt Regency Convention Center

Description:

Severely mangled limbs are fraught with multiple tissue injuries including bone, tendon, intrinsic muscles, neurovascular bundles and skin. Secondary procedures are extremely common to restore basic function. In this course, we aimed to focus on the basic principles of management and strategies to optimize the hand function. 

Topics Covered:

  1. Description, Classification and Evaluation of the Mutilated Hand:  The variety and severity of mangled hand injuries has led to the development of several grading scales, classifications and algorithms to help the surgeon organize the treatment plan.  We discuss some of these classification schemes in determining and predicting the functional outcome after reconstruction.
  2. What Functions Do We Need to Restore?  Various functions of the hand including grip (hook, power, span, chuck), pinch (key, precision, chuck) can be simplified to think of the hand as containing 4 functional units: (1) an opposing thumb, (2) fixed units of index and long, (3) more mobile ring and small fingers and (4) the wrist.
  3. Fracture Fixation in Mutilated Hand:  Skeletal stabilization is the foundation for wound management and enhances the healing of tissue repairs and reconstruction, including replantation.  In this lecture, we specifically discuss various fracture types and implant designs in addition to timing and the choice of bone grafts.
  4. Soft Tissue Coverage Options: Local, regional and distant flaps.  The concept of early rehabilitation depends on early coverage. We discuss various coverage options and how to balance them with the experience of the treating hand surgeon.
  5. Replantation/Revascularization in Mutilated Hand:  Not all amputees benefit from or are candidates for replantation. The decision to attempt replantation of a severed part is influenced by many factors, including the part, level of injury, expected return of function, mechanism of injury and psychosocial status of the patient.  We discuss basic replantation techniques and those factors affecting the outcome.
  6. Case Examples on Specific Injury Types and Reconstruction: Case examples of radial-sided, ulnar-sided, dorsal-sided, volar-sided and mid-palmar mutilating hand injuries will be discussed with the audience.

Learning Objectives:

  • Define basic functions of the hand we need to restore.
  • Identify factors affecting the choice of implant and the timing bone grafting.
  • Describe timing and various options for soft tissue coverage.
  • Characterize complex reconstructive options.
  • Define the expected outcome.

Faculty:

Steven C. Haase, MD
Jeffrey N. Lawton, MD
Jennifer F. Waljee, MD, MS

View faculty disclosures here

 

IC06: Expanding your Practice into Tetraplegia

Moderator: Dan A. Zlotolow, MD
Location: Gold Coast, Hyatt Regency Convention Center

 

Description:

The goal of this symposium is to provide the community or academic hand surgeon with a roadmap, both logistically and clinically, to be able to care for this underserved and deserving patient population.  This is an area of hand surgery, which requires no special skills, reimburses handsomely, serves a true need in our communities and is personally rewarding.  The participant will learn 1) strategies for patient recruitment, 2) health concerns in this unique population, 3) physical examination, 4) surgical planning and techniques and 5) post-operative rehabilitation. Detailed surgical techniques will be presented for biceps-to-triceps tendon transfer, brachioradialis to either ECRB and FPL, ECRL to FDP, and ECU opponensplasty.

Learning Objectives:

  • Recruit patients with Tetraplegia to consider surgical options.
  • Convince physiatrists and spine surgeons of the merits of hand surgery for Tetraplegia.
  • Examine patients with Tetraplegia and understand their special needs.
  • Perform the 3 most common tendon transfers in this population.
  • Develop post-operative rehabilitation protocols.

Faculty:

Scott H. Kozin, MD
Vincent R. Hentz, MD
Catherine Curtin, MD
View faculty disclosures here

 

IC07: Evaluation, Surgical Treatment, and Post-Operative Therapy for the Upper Extremity in Cerebral Palsy

Moderator: Michelle G. Carlson, MD
Location: Toronto, Hyatt Regency Convention Center

Description:

Patients with Cerebral Palsy may develop upper extremity contractures and deformities due to imbalances in muscle tone, leading to limitations in function.  Upper extremity reconstructive surgery can correct deformity and rebalance the muscles to increase functional use and improve hygiene and cosmesis.  This course will provide an overview of the pre-operative evaluation, surgical planning and treatment and post-operative therapy of the upper extremity in Cerebral Palsy.  Through an interdisciplinary approach, the evaluation of the child with Cerebral Palsy will first be discussed including important points in the history and physical examination.  Pre- operative evaluation including videotaping will be reviewed along with the use of Botox.  A scheme for an operative plan will be developed with goals, guidelines and options for surgical intervention.  

A discussion of surgical and non-surgical treatment options for upper extremity will be presented for:  

  • Shoulder deformity 
  • Elbow flexion 
  • Forearm pronation  
  • Wrist flexion 
  • Digital flexion & swan-neck deformity  
  • Thumb-in-palm deformity

Post- surgical therapy will be reviewed including splinting, therapeutic exercises and activities, precautions based on surgical procedures performed, and constraint induced therapy. 

Upon completion of this course, participants will feel comfortable evaluating and treating upper extremity deformities in Cerebral Palsy. 

Learning Objectives:

  • Assessment and pre-operative evaluation of upper extremity.
  • Familiarity with surgical treatment options.
  • Management of post operative rehabilitaton following upper extremity.

Faculty:

L. Andrew Koman, MD
Ann E. Van Heest, MD
Lorene C. Janowski, OTR/L, MS
View faculty disclosures here

 

IC08: Brachial Plexus Injury: A Case-based Approach to Treatment

Moderator: Steve K. Lee, MD
Location: Plaza A, Hyatt Regency Convention Center

Description:

Over the last two decades, dozens of novel nerve transfers have revolutionized the care and recovery of patients with catastrophic nerve injuries of the upper extremity.  Outcomes of muscle strength and range of motion have dramatically improved given the shorter reinnervation distances and high axonal counts of nearby transfer donors.  Time honored techniques of nerve grafting, intercostal nerve transfer, arthrodesis and tendon transfer continue to play a major role in the comprehensive management of complex plexus injuries.  The panel will use several complex cases to illustrate an integrative approach to plexus workup and management that combines microsurgical and standard reconstructive approaches for optimal outcomes of these injuries.  This course will be a case-based approach to act as a platform for an active discourse among the moderator, faculty and attendees.  Several cases will be presented that introduce controversies and highlight new ideas and approaches based on the experience of an international faculty.  Focused short presentations will be interspersed to support the panelists’ opinions and review what, if any, evidence exists for decisions for best practices.  Video demonstrations of established and cutting-edge techniques will complement each case presentation.

Case List and Controversies:

  • 5-6-7 Supraclavicular Injury
    • Controversies
      • Role of Long vs. Short Nerve Grafts
      • How do you restore deltoid function with a denervated triceps?
  • Complete plexus injury
    • Controversies
      • Can hand function be restored?
      • Use of Intercostal Nerves in 2011
      • What is the role for free muscle transfer?
      • Does the contralateral C7 transfer provide useful function?
  • Late Presentation Lower Trunk
    • Controversies
      • Tendon Transfers for Intrinsic Function
      • The Role of Arthrodesis
      • How late can distal nerve transfers be performed?
  • Late Presentation Upper Trunk
    • Controversies
      • Is shoulder arthrodesis an option?
      • Best Candidate for Free Gracilis Transfer

Learning Objectives:

  • Discuss the latest trends worldwide in the treatment of brachial plexus injuries.
  • Develop an algorithm for diagnosis, diagnostic imaging, electrodiagnostic testing and treatment.
  • Describe outcomes of techniques of nerve reconstruction in complex injuries.
  • Define the indications for nerve, vascularized muscle and tendon transfers based on staging and chronicity of the injury.
  • Recognize frontiers for growth in biologic stimulation of nerve recovery.

Faculty:

Allen T. Bishop, MD
Susan E. Mackinnon, MD
Panupan Songcharoen, MD
Scott W. Wolfe, MD

IC09: Scapholunate instability: Advanced Reconstructive Techniques

Moderator: Gregory I. Bain, FRACS, PhD
Location: Columbus I-L, Hyatt Regency Convention Center

Description:

The main focus of the ICL will be on the surgical options for stabilization of the scapholunate interval.  The characteristic findings of scapholunate instability and the anatomical factors leading to the instability will be briefly be presented.  There will be presentations on new arthroscopic assisted techniques: modifications, tips and tricks of the traditional techniques and new open reconstructive methods of stabilizion of the scapholunate interval.  The indications of when to proceed to salvage options will be discussed.

Learning Objectives:

  • Identify the clinical problem of scapholunate instability.
  • Assess the minimally invasive options of stabilisation of scapholunate instability.
  • Describe the tips and tricks to optimise the outcome of the traditional open techniques.
  • Describe new methods of stabilizing the scapholunate interval.

Faculty:

Bassem T. Elhassan, MD
Michael J. Hayton, MBChB
Mark Ross, MD

IC10: Cutting Edge Concepts on the Distal Biceps Tendon

Moderator: Christopher C Schmidt, MD
Location: Plaza B, Hyatt Regency Convention Center

Description:

This course is designed to provide the audience with cutting edge anatomic, biomechanical and clinical research on the distal biceps tendon.  It covers controversial topics like endoscopic treatment of partial biceps tears to emerging concepts on repair site location.   

Over fifty percent of the course time is devoted to lively banter during the “What’s in What’s out!” section.  Audience participation will be encouraged.  

  • Anatomy and Biomechanics  
    • Anatomy of the Biceps Tendon and Lacertus 
    • Footprint Anatomy of the Short and Long Head 
    • Biomechanical Roles of the Short and Long Head in Supination and Flexion 
  • Emerging Concepts  
    • Non-anatomic Footprint Repair Leads to a Loss of Supination Torque 
    • The Biology of a Repaired Distal Biceps and its Effect on Outcome 
    • Does an anatomic repair lead to return of normal supination strength? 
  • Surgical Techniques  
    • Open vs. Endoscopic Treatment of Partial Tears 
    • Complete Tears Acute and Chronic 
  • Conservative Care Outcomes/Complications 
  • “What’s in What’s out!” - Audience and Panel Discussions  
    • Anatomic Repair? 
    • Anterior vs. Posterior Approach? 
    • Interference Screws, Anchors, Cortical Buttons (one or two)? 
    • Role of Endoscopy? 
    • Is there a down side with conservative care? 
    • Complications and Type of Training

Learning Objectives:

  • Recognize the anatomy of the native biceps tendon footprint, specifically the relationship between the short / long heads and the radial tuberosity.
  • Understand the effect that reattachment site location has on the ability of the biceps to generate a supination torque.
  • Assess the MRI appearance of a repaired distal biceps tendon and understand its effect on functional outcome.
  • Discuss the surgical treatment options for acute and chronic tears, including endoscopic treatment of partial tears.
  • Discuss outcomes of conservative treatment and basic complications and pitfalls with surgery.

Faculty:

Gregory I. Bain, FRACS, PhD
Dean G. Sotereanos, MD
Mark E. Baratz, MD
 

IC11: Treatment of Complications Following Common Elbow Procedures

Moderator: A. Lee Osterman, MD
Location: Acapulco, Hyatt Regency Convention Center

Description:

Arthroplasty Complications
  • Total Elbow Arthroplasty
  • Radial Head Arthroplasty
Nerve Complications
  • Recurrent Cubital Tunnel Syndrome
  • Nerve Injuries After Elbow Arthroscopy
Soft tissue Complications
  • Failed Lateral Epicondylar Surgery
  • Failed Ligament Repairs
Pediatric Complications
  • Supracondylar Fractures
  • Monteggia Fracture Dislocations  
This course will present common complications of common procedures performed about the elbow in adults and children.  Treatment strategies for the complications will be presented as well as ways to avoid their occurrence.  Teaching methods will include illustrative cases.

Learning Objectives:

  • Understand the complications associated with common surgical elbow procedures.
  • Provide pearls and pitfalls for the avoidance of such complications.
  • Aid the hand surgeon in managing these complications.

Faculty:

Scott P. Steinmann, MD
Julie E. Adams, MD
Joshua M. Abzug, MD

IC12: Tendon Transfers for the Upper Extremity: Restoring Function Following Nerve Injury

Moderator: Fraser J. Leversedge, MD
Location: Comiskey, Hyatt Regency Convention Center

Description:

Using a case-based format, tendon transfers for nerve injuries affecting the upper extremity will be reviewed, including strategies for the timing of surgery, surgical approaches and donor options for individual and multiple nerve deficits.  Pearls and pitfalls, as well as outcomes, will be discussed.

Learning Objectives:

  • Recognize options for tendon transfers following peripheral nerve injuries.
  • Consider various tendon transfers for specific nerve deficits.
  • Evaluate strategies for the timing and surgical approaches for various tendon transfers of the upper extremity.

Faculty:

John G. Seiler, III, MD
Dan A. Zlotolow, MD
Sanjeev Kakar, MD, MBA

IC13: Intrinsic Flaps of the Hand

Moderator: Sandeep J. Sebastin, MCh
Location: Regency C, Hyatt Regency Convention Center

Description:

Presentations will cover specific aspects of intrinsic flaps followed by a Q&A session:
How to Match the Flap to the Defect
  • Size of Defect vs. Size of Flap
  • Location of Defect
  • Vascularity of the Flap 
Advancement Flaps (VY, Moberg)
  • Flap Elevation
  • Pearls and Pitfalls 
Cross Finger Flap 
  • Flap Elevation
    • Multiple Digits
    • Vascular Island Cross Finger
  • Pearls and Pitfalls 
Vascular Island Flaps (Homo, heterodigital, and reverse vascular island) 
  • Flap Elevation
  • Pearls and pitfalls 
Dorsal Metacarpal Artery Perforator Flap
  • Flap Elevation
  • Pearls and Pitfalls

Learning Objectives:

  • Understand selection of the intrinsic flap for a given digital defect.
  • Understand vascular anatomy of intrinsic flaps.
  • Explore the technical pearls and pitfalls of common intrinsic flaps: Advancement flaps (VY and Moberg); Cross finger flap; Vascular island flaps (Homo, heterodigital, and reverse vascular island); Dorsal metacarpal artery perforator flap.

Faculty:

Peng Yeong Pin, MD
Pravit Kitidumrongsook, MD
Teemu Karjalainen, MD
Wing-Lim Tse, MD

IC14: The Use of Ultrasound in the Treatment of Hand and Upper Extremity Pathology

Moderator: Jeffrey Brault, MD
Location: Regency A, Hyatt Regency Convention Center

Description:

High frequency ultrasound is increasingly being utilized in clinical practice.  Ultrasound is an inexpensive, portable and effective way of identifying anatomical structures within the hand and wrist.  During this discussion, we will review pertinent upper extremity neuromusculoskeletal structures, abnormal ultrasound findings found in common hand and wrist conditions and relevant ultrasound guided modalities utilized in the management of hand and upper extremity pathology.  During the course, participants will become familiar with the use of ultrasound in diagnosing and treating common hand problems such as lateral epicondylitis, trigger finger,  hand and wrist arthritis, Dupuytren’s disease and carpal tunnel syndrome.

Learning Objectives:

  • Understand the basic science and uses of ultrasound as both a diagnostic and therapeutic.
  • Review basic anatomy of the hand and upper extremity via the use of ultrasound.
  • Review basic injection techniques of the wrist and hand utilizing ultrasound.

Faculty:

Marco Rizzo, MD
Jay Smith, MD
Steve Wisniewski, MD
 

© 2014 American Society for Surgery of the Hand | Contact Us  |  Future Meetings  |  Meeting Archives  |  Privacy Policy | Disclaimer