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Saturday Instructional Courses

7:00 – 8:00 AM


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Instructional Course 38
Moscone West 2014

Cutting Edge Concepts on the Distal Biceps Tendon

Target Audience: Intermediate
Keyword: Elbow
Category: Tendon
Keyword: Elbow
Upon completion of this course, participants will be able to:
  • Recognize the anatomy of the native biceps tendon footprint, specifically the relationship between the short and long heads to the apex of the radial tuberosity.
  • Identify the effect that reattachment site location has on the ability of the biceps to generate a supination torque.
  • Learn the latest treatment options available for acute and chronic biceps tendon ruptures, including endoscopic treatment of partial tears.
  • Assess the MRI appearance of a repaired distal biceps tendon and understand its effect on functional outcome.
  • Discuss outcomes of conservative treatment and basic complications and pitfalls with surgery.


  1. Anatomy of the biceps footprint (short and long head).
  2. Reattachment location and its effect on the biceps moment arm.
  3. Endoscopic treatment of partial biceps tendon tears.
  4. Treatment of acute and chronic biceps tendon tears.
  5. MRI appearance of distal biceps tendon repair and comparison with functional outcome.
  6. Outcomes with conservative care.
  7. Complications and pitfalls of surgical treatment.
  8. Audience and panel discussion on selected cases
Moderator: Christopher C. Schmidt, MD
Speakers: Gregory Ian Bain, FRACS, PhD, Mark E. Baratz, MD, Dean Sotereanos, MD

Instructional Course 39
Moscone West 2016

Denervation of the Wrist: An Alternative Palliative Treatment for Chronic Wrist Pain

Target Audience: Basic
Keyword: Wrist
Category: Arthritis
Upon completion of this course, participants will be able to:
  • Identify the major sensory innervation pathways for the wrist joint.
  • Recognize the back normal function of mechanoreceptors in the wrist.
  • Safely perform selected wrist denervation procedures.
Chronic wrist pain due to arthritis is often debilitating.  Traditional surgical procedures to salvage the wrist joint can be effective in treating pain, but require extensive rehabilitation and often compromise wrist range of motion.  Denervation of the wrist offers a low risk viable alternative to fusions and carpectomies.  By understanding the innervation of the wrist and undersatnading the diminished role of mechanoreceptors in an arthritic wrist, a surgeon can confidently proceed with partial or total denervation of the wrist.  This offers a high percentage of clinical success by directly interrupting the pathway by which afferent pain impulses are transmitted to the brain.  Range of motion is unaffected, the procedure and postoperative period are dramatically shorter than typical salvage procedures, and there are no bridges burned for future procedures, should they become necessary.
Moderator: Richard A. Berger, MD, PhD
Speakers:  Keizo Fukumoto, MD, A. Lee Dellon, MD, PhD

Instructional Course 40
Moscone West 2018

Utilizing iPhone and iPad Apps in a Hand Surgery Practice

Target Audience: Intermediate
Keyword: Other
Category: Practice Management
Upon completion of this course, participants will be able to:
  • Recognize different strategies for accessing your patient data on an iPhone/iPad.
  • Share and discover the numerous apps that are out there to help you in your practice.
  • Recognize real life examples are given of how these devices and apps can be helpful to the clinician.
The spread of smartphones and tablet devices has changed how physicians can access data.  Healthcare has been accused of being slow to implement IT solutions to patient care facilities.  However physicians have been utilizing these new devices at ever-increasing rates.  Because of this, physicians are now demanding that IT services support these devices to help them access the data that is critical for patient care.  The iPhone and the iPad have proven to be particularly popular with doctors.  One of the key factors to the success of these devices has been the large number of apps, and specifically healthcare related apps.  This course is meant to educate the hand surgeon on a few of the common apps and implementation strategies for these devices in a hand surgery practice.
Moderator: Scott Duncan, MD, MPH
Speakers: Rick F. Papandrea, MD

Instructional Course 41
Moscone West 3000/3002

Shades of Gray – MRI Basics

Target Audience: Basic
Category: MRI, Imaging
Upon completion of this course, participants will be able to:
  • Obtain a basic understanding of the musculoskeletal radiologist's approach to interpretation of wrist, digit and elbow MRI examinations.
  • Gain understanding as to the clinical applications and limitations of MRI in the wrist, digit and elbow.
  • Become familiar with the basic anatomy of the wrist, digit and elbow as demonstrated on MRI.
This course will be a one hour case-based presentation demonstrating the approach to interpretation of wrist, digit and elbow MRI with a panel of radiologists and orthopedic surgeons.  In this session, some common pathological conditions will be presented with a discussion of the use of MRI for these conditions.  The MRI findings will be discussed followed by a tutorial of how a musculoskeletal radiologist interprets these examinations using a checklist approach. 
Moderator:  Geoffrey M. Riley, MD
Speakers: Christopher Beaulieu, MD, Nader Paksima, DO, MPH, Harry A. Hoyen, MD

Instructional Course 42
Moscone West 2020

What Do These Statistical Tests Mean? How to Evaluate the Clinical Research Studies You Read

Target Audience: Basic
Keyword: Other
Category: Other
Upon completion of this course, participants will be able to:

Identify the implications of statements commonly made in clinical research studies so that, as readers, they can judge when the authors’ conclusions are reasonable and, more importantly, when they are not.
The session will focus on the meaning of statistical analyses commonly used in clinical research.  The topics that will be covered will include issues related to study sample size and statistical power, hypothesis testing and modeling.
Moderator: Brent Graham, MD

Instructional Course 43
Moscone West 2022

How to Review Manuscripts for the Journal of Hand Surgery

Target Audience: Intermediate
Keyword: Other
Category: Other
Upon completion of this course, participants will be able to:
  • Format critical yet helpful reviews.
  • Structure reviews to facilitate the authors’ revisions and the reviewers’ reassessments.
  • Assess figures and tables for their clarity and value.
  • Act ethically regarding peer review’s need for confidentiality and avoidance of bias and conflict.
Peer review of original research involves both teaching and learning.  Reviewers help authors clarify their message both in content and form.  In the process, reviewers enhance their own critical thinking skills, which make them better practitioners, reviewers, investigators and teachers.  When the manuscript reaches publication, the reviewer takes pride in having integrally contributed to the advancement of hand surgery.
Dr. Meals brings to the course his decades of experience as an author, reviewer and now editor of the Journal of Hand Surgery.  He will describe the history and process of peer review and, most importantly, cover in detail the mechanics of preparing a meaningful review. 
On course completion, Dr. Meals will invite interested participants to become consultant reviewers for JHS and apply their newly gained skills.  Associate editors rise from the ranks of consultant reviewers based on their sustained return of timely and meaningful reviews.
Moderator: Roy A. Meals, MD

Instructional Course 44
Moscone West 2002

Diagnosis and Management of Cartilage Tumors of the Hand and Upper Extremity: A Case Based Discussion

Target Audience: Intermediate
Keyword: Hand
Category: Tumor
Upon completion of this course, participants will be able to:
  • Recognize the key clinical and diagnostic imaging features of the most common benign and malignant cartilage tumors of the hand and upper extremity.
  • Discuss the indications for and principles of bone biopsy.
  • Review the treatment options, surgical techniques and technical tips for tumors of chondrogenic origin in the upper limb.
  • Understand the latest treatment alternatives  and controversies associated with tumors of cartilage origin in the upper limb including bone grafting for, and malignant degeneration of, an enchondroma, management of pathological fractures, limb salvage for chondrosarcoma, as well as the evaluation and management of the patient with multiple osteochondromatosis, Ollier’s and Maffucci’s syndrome.
Cartilage tumors of the hand and upper extremity are well recognized and represent a spectrum of disease.  Using illustrative cases with audience participation, this instructional course will present an overview of the most common benign and malignant tumors of chondrogenic origin in the upper limb.  We will review the clinical and radiographic features, biopsy principles and treatment options for each tumor type as well as the anticipated outcomes and recurrence rate following treatment.  Indications for neoadjuvant and adjuvant therapy will be reviewed for chondrosarcoma  the diagnosis and management of multiple osteochondromatosis, Ollier’s and Maffucci’s syndrome will also be reviewed including a discussion of the  latest treatment alternatives and controversies associated with these unusual conditions.
Moderator: Peter J. L. Jebson, MD
Speakers: Peter M. Murray, MD, Edward A. Athanasian, MD, Brian T. Carlsen, MD

Instructional Course 45
Moscone West 3001/3003

Techniques of SLAC Wrist Reconstruction: Can We Spare Motion and Maximize Function?

Target Audience: Intermediate
Keyword: Wrist
Category: Arthritis
Upon completion of this course, participants will be able to:
  • List functional activities that utilize midcarpal motion.
  • Evaluate advantages and disadvantages of midcarpal-sparing partial arthrodesis.
  • Identify selection criteria for proximal row carpectomy and partial intercarpal fusion.
  • Describe techniques of intercarpal fusion that maximize joint motion.
  • Evaluate the role of wrist arthroplasty in post-traumatic arthritis.
Traumatic disruption of the proximal carpal row leads to an inexorable degenerative spiral, escalating pain and loss of function in a young active patient population.  Standard palliative techniques of limited intercarpal fusion and proximal row carpectomy have stood the test of time but necessarily sacrifice coordinated carpal row motion and limit functional ability.  Kinematic research has detailed a correlation between midcarpal joint motion and functional activities, and recent clinical and basic studies have detailed surgical techniques to maximize midcarpal motion.  The panel will discuss current and emerging solutions to a common and debilitating condition and reveal their tips and tricks to optimize success of these challenging surgeries.
Moderator: Scott W. Wolfe, MD
Speakers: Alberto L. Lluch, MD, Hisao Moritomo, MD, PhD, Steve K. Lee, MD, Marco  Rizzo, MD
Scott W. Wolfe, MD's presentation will include discussion of KinematX wrist hemiarthroplasty, an "off-label" or other non-FDA approved, investigational pharmaceutical product or device manufactured by Extremity Medical.

Instructional Course 46
Moscone West 2004

PIP Joint Fracture Dislocations: Evaluation and Treatment

Target Audience: Intermediate
Keyword: Hand
Category: Fractures and Dislocations
Upon completion of this course, participants will be able to:
  • Understand indications for nonoperative treatment of PIP joint injuries.
  • Understand principles for evaluation and treatment of PIP joint fracture dislocations.
  • Evaluate and chose between treatment options for PIP fracture dislocations.
  • Understand postoperative management and complications associated with PIP joint injuries.
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.
Moderator: Julie E. Adams, MD
Speakers: Robert J. Strauch, MD, O. Alton Barron, MD, Ryan P. Calfee, MD

Instructional Course 47
Moscone West 2006

Cosmetic Rejuvenation of the Hand

Target Audience: Intermediate
Keyword: Hand
Category: Evaluation/Diagnosis/Clinical Treatment
Upon completion of this course, participants will be able to:
• Evaluate and recognize cosmetic issues regarding the hand.
• Analyze non operative techniques of hand rejuvenation.
• Discuss fat grafting and stem cell techniques specific for the hand.
• Apply operative techniques to rejuvenate the hand.
• Recognize complications of hand rejuvenation.
Rejuvenation of the hand has gained considerable popularity as the techniques and experience have improved over the past several years, and subsequently patient request for hand rejuvenation has increased.  Taking the patients cosmetic complaints about their hands and translating them into anatomic problems is the first step in hand rejuvenation.  Issues such as "age spots" and  skin rhytidies can be treated with laser therapy with little risk of  complications.  In-office soft tissue "fillers" can be applied to fill soft tissue deficiencies in the aging hand.  Many types of FDA approved fillers are available, and the pros and cons of the use of these fillers in hand rejuvenation will be discussed.  Fat grafting and, more recently, "stem cell" use has gained popularity in rejuvenating soft tissue deficiencies of the hand.  The concept and difference between fat grafting and stem cell use will be discussed.  The techniques of injecting and harvesting fat for either fat grafting or stem cell transplant will be discussed as well as the postoperative care.  Other issues such as prominent veins and nonfunctional bone abnormalities will be addressed.  Finally, the complications of hand rejuvenation will be covered as well as treatment options that address such complications.
Moderator: David A. Kulber, MD
Speakers: Roger K. Khouri, MD, Mark Rekant, MD, Joel A. Aronowitz, MD

Instructional Course 48
Moscone West 2008

Musculoskeletal Ultrasound for the Hand Surgeon: A Course by Hand Surgeons for Hand Surgeons

Target Audience: Advanced
Keyword: Hand
Category: Evaluation/Diagnosis/Clinical Treatment
Upon completion of this course, participants will be able to:
• Recognize the evolving role of Ultrasound in Hand surgical practices.
• Gain appreciation  of  ultrasound's value as a diagnostic tool in the upper extremity.
• Identify  when ultrasound is the diagnostic tool of first choice.
• Appreciate how ultrasound guided injections will add safety and accuracy to office and surgical practices.
• Assess the financial impact of ultrasound on hand surgery practices.
We will, by the use of clinical case material, demonstrate the value of ultrasound as a diagnostic and clinical tool for hand surgeons.  The faculty, made up of ASSH members, will share the value added to their practices by the use of this modality.
We will explain why we feel that ultrasound, like x-ray, belongs in every hand surgeon's office.
Moderator: George W. Balfour, MD
Speakers: Brian M. Jurbala, MD, Michael Travis, MD

Instructional Course 49
Moscone West 3014

I Spy for Hand Surgeons – Recognition and Treatment of Common Skin Conditions Seen of the Hands

Target Audience: Basic
Keyword: Hand
Category: Evaluation/Diagnosis/Clinical Treatment
Upon completion of this course, participants will be able to:
  • Discuss the diagnosis and treatment of skin lesions commonly encountered on the upper extremities.
  • Provide pearls and pitfalls for the management of benign and malignant skin lesions commonly seen on the upper extremity.
  • Aid the hand surgeon in knowing how to manage complications associated with common skin lesions encountered on the upper extremities.
Diagnosis and management of common benign and malignant skin lesions encountered on the upper extremities will be presented.  Detailed discussion regarding pearls and pitfalls to avoid. missing malignant lesions as well as management of all lesions will aid the hand surgeon in their practice.
Moderator: A. Lee Osterman, MD
Speakers: Earl J. Fleegler, MD, Mark Rekant, MD, Megha M. Tollefson, MD

Instructional Course 50
Moscone West 3016

Caring for the Pediatric/Adolescent Athlete

Target Audience: Intermediate
Keyword: Other
Category: Congenital/Pediatric
Upon completion of this course, participants will be able to:
  • Understand the potential causes of upper extremity conditions that occur in pediatric/adolescent athletes.
  • Provide pearls and pitfalls for the diagnosis and treatment of upper extremity conditions in pediatric/adolescent athletes.
  • Aid the hand surgeon in avoiding potential complications of treatment.
This course will present common causes of upper extremity pain in pediatric/adolescent athletes.  Diagnostic and treatment strategies will be presented as well as ways to avoid complications.  Teaching methods will include illustrative cases.
Moderator: Donald S. Bae, MD
Speakers: Charles A. Goldfarb, MD, Joshua M. Abzug, MD

Instructional Course 51
Moscone West 3018

Advances in Microsurgical Reconstruction of the Hand and Upper Extremity—Microsurgery, Supermicrosurgery and Beyond

Target Audience: Intermediate
Keyword: Hand
Category: Vascular/Microvascular
Upon completion of this course, participants will be able to:
  • Summarize the concepts of supermicrosurgery, including technical aspects of cutting-edge perforator-to-perforator flaps.
  • Describe advanced techniques for toe-to-hand transfers, including toe-tip transfers for fingertip reconstruction.
  • Describe the potential benefits of vascularized nerve flaps compared to non-vascularized nerve grafts.
  • Identify various island perforator flaps that can be performed for hand reconstruction.
“We were standing on the shoulders of a giant and decided to go a step further.”—G. Ian Taylor, MD, on the evolution of microsurgery, first developed by Harry Buncke, MD.
In 1964 Dr. Harry Buncke, the “Father of Microsurgery,” successfully replanted a rabbit ear in his garage, marking the birth of microsurgery.  Since then, microsurgery has evolved rapidly, and newer techniques continue to be developed.  This instructional course lecture will focus on advances in microsurgery and supermicrosurgery, as presented by two leading international innovators in microsurgery.
In this course, we will introduce new and exciting advances in microsurgery, including:
  1. Supermicrosurgery (perforator-to-perforator flaps): Anterolateral thigh (ALT) perforator flap, modified thoracodorsal artery perforator (TAP) flap, superficial circumflex iliac artery perforator (SCIP) flap and the “Miami flap”;
  2. Advances in toe-to-hand transfers, including toe-tip transfers for fingertip reconstruction;
  3. Vascularized nerve flaps for improved nerve regeneration, including vascularized lateral femoral cutaneous nerve and vascularized deep peroneal nerve flaps; and
  4. Island perforator flaps for the hand.
It has been almost 50 years since Harry Buncke performed the first successful microsurgical procedure in his garage, and microsurgery continues to evolve.  Participants of this course will learn microsurgical techniques of the hand and upper extremity that challenge reconstructive norms from distinguished international faculty that are truly living “giants” of microsurgery.
Moderator: Jason H. Ko, MD
Speakers: Chih-Hung Lin, MD, Isao Koshima, MD

Instructional Course 52
Moscone West 3020

Pearls for Success Early in a Hand Surgery Practice

Target Audience: Intermediate
Keyword: Hand
Category: Practice Management
Upon completion of this course, participants will be able to:
  • Describe common critical features (malpractice insurance options, buy-in’s, non-compete clauses) for employment contracts early in practice.
  • Decide when to incorporate new literature into their evidence-based practices.
  • Apply lessons from the “surgeon as an educator” lecture to their practice and incorporate techniques learned to the optimal education of staff and trainees.
  • Identify techniques necessary for conducting meaningful scientific investigation while remaining clinically productive.
This 90 minute ICL highlights universal issues that hand surgeons encounter in the first 5 years of practice.  The ICL will consist of 4 x 15 minute talks, followed by an interactive 30 minute question and answer session for the audience to discuss issues with the panel of speakers.  Participants will be encouraged engage the panelists regarding any issue pertinent to their practice, and not to feel limited to the topics discussed during the formal lectures.  This ICL is designed to appeal to surgeons entering both private and academic practices.  To this end, each didactic will focus on details that are widely applicable to young surgeons early in practice.  This course will introduce critical concepts relevant to growing a practice, incorporating new evidence into one's practice, the surgeon as an educator and foundations for the surgeon scientist.  Emphasis will be made on specific details of each topic to maximize the ease of lesson incorporation into audience members’ practices.
Moderator: Alexander M. Spiess, MD, Ryan P. Calfee, MD
Speakers: James Chang, MD, David J. Bozentka, MD, Gregory Merrell, MD, Warren C. Hammert, MD


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