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ASSH Keynote Lectures:
Presidential Address
International Guest Lecture
Presidential Guest Lecture
Founder's Lecture
ASHT Keynote Lectures:
President's Lecture
Presidential Guest Lecture
International Invited Lecture
Nathalie Barr Lecture
ASSH Presidential Address
Thursday, September 3, 1:30 – 2:15 PM
Bridges to the Future: Implications of Technology and Regenerative Medicine on Hand Surgery and its Impact on Patients, Practitioners and Society
L. Andrew Koman, MD, Winston-Salem, NC
ASSH President
At the height of the Great Depression, the Golden Gate Bridge was built in spite of widespread opposition, due to the drive and perseverance of a multidisciplinary group of engineers, bankers and visionaries. As the 21st century unfolds, the discipline of hand surgery—now firmly established as a distinct medical specialty — must address the practical and ethical implications of the exponential growth of technology in the face of limited resources within a globally-challenged economy. New products from developing technology and regenerative medicine have unlimited real and potential implications on our patients, society and ourselves. How we deal with the resultant diagnostic, non-operative interventions and surgical procedures in the presence of finite resources, contradictory conflicts-of-interest, limited scientific evidence, unlimited anecdotal and advertising input and regulatory mandates is our challenge and legacy.
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ASSH International Guest Lecture:
Friday, September 4, 11:30 AM – 12:00 PM
Unraveling the Mysteries of Congenital Hand Anomalies:
From the Molecular Orchestration of Morphogenesis to the Implications for Classification and the Principle of Management
Panayotis N. Soucacos, MD, Athens, Greece
The process of limb development has been conserved for more than 300 million years, with various important adaptations taking place throughout evolution. Recent developments in the field of hand surgery, in addition to research findings in molecular morphogenesis have resulted in significant advancements in the understanding and, subsequently, in the management of congenital differences of the hand. The developmental mechanisms involved in limb differentiation are beginning to be understood through new studies on the molecular interactions and cascade of events that play a part in orchestrating limb patterning. As these mechanisms are unraveled, more congenital anomalies seen by hand surgeons will have an identifiable molecular basis. Over the last two decades, increased experience with congenital anomalies of the hand has significantly broadened the hand surgeon’s knowledge and has resulted in new methods of classification and more effective approaches of management. The principles of treatment of various hand anomalies are constantly being refined with the addition of state-of-the-art technologies, such as free vascularized transfers, among others. Despite this exponential growth in the hand surgeon’s armamentarium, the management of congenital differences of the hand remains a demanding challenge.
The journey into the understanding of wrist mechanics has progressed significantly since 1833, when Sir Charles Bell (London, UK) stated, “In the human hand, the bones of the wrist (carpus) are so closely connected that they form a sort of ball, which moves on the end of the radius.” However, it has been a “long and winding road.” If we often got lost, fooled by misleading signposts, wrong maps or good-faith visionaries, indicating false directions, we have progressed, nonetheless. What do we know? How did we discover it? Those are the questions that a lifelong wrist enthusiast will try to answer. Are we there yet? Of course not, but the trip continues to be exciting.
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ASSH Presidential Guest Lecture
Forensic Anthropology – From Crime Lab to Crime Fiction
Friday, September 4, 3:15 – 4:15 PM
Kathleen J. Reichs, PhD, PABFA, Charlotte, NC
Join Kathy Reichs’ exciting presentation where she will discuss the science of forensic anthropology. She will discuss personal cases and share experiences that have influenced her fictional stores. Dr. Reichs also will provide a “behind-the-scenes” view of Bones, the television series based upon her character, Temperance Brennan.
Dr. Reichs’ first novel Déjà Dead catapulted her to fame when it became a New York Times bestseller and won the 1997 Ellis Award for Best First Novel. Her other Temperance Brennan novels include Death du Jour, Deadly Décisions, Fatal Voyage, Grave Secrets, Bare Bones, Monday Mourning, Cross Bones, Break No Bones, Bones to Ashes, and Devil Bones.
From teaching FBI agents how to detect and recover human remains to separating and identifying commingled body parts in her Montreal lab, as a forensic anthropologist, Dr. Reichs has brought her own dramatic work experience to her mesmerizing forensic thrillers. For years she consulted to the Office of the Chief Medical Examiner in North Carolina and continues to do so for the Laboratoire de Sciences Judiciaires et de Médecine Légale for the province of Québec. Dr. Reichs is one of only 77 forensic anthropologists ever certified by the American Board of Forensic Anthropology. She served on the Board of Directors and as Vice President of the American Academy of Forensic Sciences, and is currently a member of the National Police Services Advisory Board in Canada. She is a professor in the Department of Anthropology at the University of North Carolina-Charlotte.
Dr. Reichs is a native of Chicago, where she received her PhD at Northwestern. She now divides her time between Charlotte, NC and Montreal, Quebéc.
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ASSH Founder's Lecture
The Integration of Arthroscopy into Hand Surgery
Saturday, September 5, 11:00 – 11:30 AM
Gary G. Poehling, MD, Winston-Salem, NC
During this program, Dr. Poehling will review a history of arthroscopy starting in Japan, Europe and New York. He will then trace the beginnings of wrist arthroscopy from its conception in Austria to its first course. Arthroscopy in hand surgery has been influenced by a number of view points and many ideas from across the world. Dr. Poehling also will share his early experiences with arthroscopy. From Japanese influences to important early role models in his residency, he will tell the story that has shaped his current thoughts on the utilization of wrist arthroscopy in hand surgery.
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ASHT President’s Lecture
Making Decisions Using Values, Experience and Evidence
Thursday, September 3, 7:30 – 7:50 AM
Joy C. MacDermid, BScPT, PhD, London, Ontario, Canada
ASHT President
This presentation will address how hand therapists can integrate their clinical experience with patient values and preferences, while practicing in an evidence-based, patient-centered approach.
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ASHT Presidential Guest Lecture
Occupation-Based Hand Therapy
Thursday, September 3, 8:37 – 9:07 AM
Mary Law, PhD, FCAOT, FCAHS, Ontario, Canada
This presentation will focus on occupation-based therapy, highlighting how it forms the basis for education of occupational therapists and how it can serve as a foundation for evidence-based hand therapy.
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ASHT International Invited Lecture
The Sensational Hand and the Plastic Brain
Thursday, September 3, 9:54 – 10:24 AM
Birgitta Rosén, OT, PhD, Malmo, Sweden
Today there is no surgical repair technique that can ensure recovery of tactile discrimination in the hand of an adult patient following nerve repair, while very young individuals usually regain a complete recovery of functional sensibility. Such injuries may cause long-lasting disabilities in terms of lost fine sensory and motor functions. Posttraumatic nerve regeneration is a complex biological process where the outcome depends on multiple biological and environmental factors, such as survival of nerve cells, axonal regeneration rate, extent of axonal misdirection, type of injury, type of nerve, level of the lesion, age of the patient, cognitive capacity and compliance to training. A major problem is the cortical functional reorganization of the hand representation, which occurs as a result of axonal misdirection. Although protective sensibility usually can occur following nerve repair, tactile discriminative functions seldom recover – a direct result of the cortical remapping.
New trends in hand rehabilitation focus on modulation of central nervous processes, rather than peripheral factors. It was long believed that the cortical body map was firmly established in the adult brain, but according to evolving concepts the brain is much more plastic than was previously believed, possessing a large capacity for cortical functional reorganization, even at the adult stage. Rapid reorganizations occur as a result of changes in activity and sensory inflow. In addition, the brain possesses a cross- and multimodal capacity, implying that one sense can substitute for another.
After nerve injury, following activity changes and long-term exposure to a specific activity, the cortical hand area becomes disorganized, diminishes or may disappear, a fact which may seriously jeopardize hand function. Sensory re-education may be of importance not only after a nerve reconstruction. It may, however, be as important in situations with a just slightly changed somatosensory cortex to maintain or restore the cortical somatosensory patterns, in order to facilitate the sensori-motor neural networking.
Following repair of major nerve trunks there is initially a period (phase 1) lasting for several months when no regenerating fibers have reached the distal parts of the hand, followed by (phase 2) representing re-innervation of the hand. Each of these phases requires a specific treatment strategy, and sensory re-education should begin immediately after nerve repair to preserve the cortical hand representation.
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ASHT Nathalie Barr Lecture
And Don’t Forget to Smile
Friday, September 4, 8:40 – 9:10 AM
Karen H.P. Lauckhart, MA, PT, CHT, New Canaan, CT
When Lauckhart became President of ASHT in 1979, the hand therapy specialty and society were in their infancy. In the 30 years hence, there have been dramatic changes to both. Recent challenges to the efficacy of treatment methods and the effectiveness of our Society has given Lauckhart pause to question: Was it all worth it? Did she make the right choice specializing in hands? Did the Society meet its objectives and expectations? Her perspective is that ASHT has enhanced the world-wide professional standing and patient outcome has been enriched.
She has also come to understand that her goal is a life of balance between professional aspirations and personal fulfillment. Considering her personality, she is confident that a career of service was a worthwhile choice and being a specialist afforded her freedom to focus on quality workmanship. High productivity levels and job loyalty are admirable qualities, but taking the time for personal pursuits is of equal importance. Absent this balance, there is strong likelihood that patient care will suffer. So, in the end, both therapist and patient will benefit from the pursuit of a well-balanced life.
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