Surgeon Track
Therapist Track
4:30 - 6:00 PM
- HS-IC17
Diagnosis and Management of Malignant Tumors of the Upper Extremity
Audience Level: Intermediate
Chair: Peter M. Murray, MD, Jacksonville, FL
- Faculty: Edward A. Athanasian, MD, New York, NY; Peter J. L. Jebson, MD, Ann Arbor, MI
- Objectives:
• Define the appropriate workup for suspicious lesions of the upper extremity
• Apply the fundamentals of performing a biopsy of worrisome bone and soft tissue tumors of the upper extremity
• Describe current treatments for specific bone and soft tissue tumors of the upper extremity, including resection techniques and the basic principles of limb salvage surgery
• Recognize soft tissue reconstructive options following resection of soft tissue sarcomas of the upper extremity, including free tissue transfer
• Discuss reconstructive options for bone defects following resection of benign and malignant bone tumors of the upper extremity including vascularized bone transfer
Description:
Awareness of upper extremity bone, soft tissue and skin malignancies is paramount for the practicing hand surgeon. This course will discuss the appropriate work up for worrisome lesions of the upper limb as well as a discussion for the indications and techniques of biopsy. Examples will be given demonstrating adequate and inadequate biopsy specimens. General principles of histology evaluation will be reviewed including appropriate tumor grading. A detailed discussion of the more common bone, soft tissue and skin malignant tumors will be provided. The latest techniques in bone and soft tissue tumor surgery will be discussed including the salient features of tumor resection surgery with emphasis on obtaining adequate margins and preparing the limb for salvage reconstruction. The basic principles of limb salvage surgery will be reviewed including an overview of defect management including techniques for pedicled and free tissue transfer. Additionally, long bone reconstructive options such as free vascularized fibular transfer will be discussed The goals of limb sparing surgery will be explained in the context of specific tumor conditions, illustrating for the attendee the importance of balancing “function” and “cure.” The current recommendations for neo-adjuvant and adjuvant treatments will be outlined, including the indications for chemotherapy and radiation therapy. Each section of the course will be enhanced with multiple tumor cases and invited audience participation. At the conclusion of the instructional course, the participant will be able to apply the basic principles of biopsy to his or her practice as well as be able to recognize different grades of malignant tumors. The participant will be able to describe current tumor resection techniques as well as options for adjuvant treatment. Also, the attendee will be list the options available for defect management following tumor resection surgery of the upper limb.
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HS-IC18
Shoulder Arthroplasty for the Hand Surgeon
Audience Level: Intermediate
Chair: Ethan R. Wiesler, MD, Winston-Salem, NC
Faculty: Dean G. Sotereanos, MD, Pittsburgh, PA; Scott P. Steinmann, MD, Rochester, MN; Jeffrey Lovallo, MD, Arlington, VA
Objectives:
• Understand the basic surgical approaches to shoulder arthroplasty
• Understand the indications for partial, resurfacing, hemi and total shoulder arthroplasty
• Understand the treatment of rotator cuff deficient shoulders
• Be familiar with the indications for a reverse shoulder replacement
Description:
This course will cover the basics of shoulder arthroplasty, including positioning, surgical approach, implant selection and post-op regimen.
The course will be broken down into three main sections:
Basics-surgical approach and implant options
Indications-hemi vs. total shoulder replacement, role of the resurfacing arthroplasty and reverse arthroplasty
Special topic-treatment of the rotator cuff deficient shoulder and complications of shoulder replacement
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HS-IC19
Thumb CMC Arthroplasty: What We Think We Know . . . and Don’t
Audience Level: Basic
Chair: Arnold-Peter C. Weiss, MD, Providence, RI
Faculty: Amy L. Ladd, MD, Palo Alto, CA; Joseph J. Trey Crisco, III, MD, Providence, RI; Wendy M. Murray, PhD, Palo Alto, CA
Objective:
Review what we know about the anatomy, kinematics and surgical treatment of the arthritic thumb carpometacarpal (CMC) joint, as well as present future directions in arthroplasty techniques and research. Common misconceptions regarding arthroplasty of the thumb will be discussed.
Description:
This Instructional Course will review what we know about the anatomy, kinematics and surgical treatment of the arthritic thumb carpometacarpal (CMC) joint, as well as present future directions in arthroplasty techniques and research. Two simultaneous presenters will provide a fast-paced but interactive summation of where we stand today and where we are going as hand surgeons and scientific investigators. We will highlight conclusions and misconceptions of published treatment outcomes and present this information to allow the audience to form their own conclusions. The intended goal for the audience is to leave with a comprehensive understanding of why and what we do to treat this joint after a controversial and stimulating discussion.
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HS-IC20
Reconstruction of the Burned Upper Extremity in Adults and Children
Audience Level: Intermediate
Chair: Roger L. Simpson, MD, MBA, Garden City, NY
Objectives:
• Understand the pathophysiology of the burn injury relative to the hand
• Identify and treat all degrees of acute burns of the hand
• Understand the role and limitations of therapy
• Plan optimal reconstruction procedures to increase hand function
• Understand advanced techniques using tissue expansion and alternative tissue coverage
Description:
Purpose: This course will discuss the burned hand and upper extremity in both adults and children from acute injury and early management through reconstruction and maximum return of function.
Acute Period: Discussion of acute burn management will include the pathophysiology of the burn injury and its impact on the hand. Treatment of the acute injury, emphasizing the depth of injury on the thin skin and fragile joints, is detailed through algorithms and clinical cases. Choice of initial treatment plans will influence the quality of scar deformity and the possible prevention of functional contracture.
Reconstructive Period: The timing and type of surgical reconstruction following initial healing will be given the greatest emphasis. The planning of burn scar reconstruction requires a thorough understanding of scar contraction and tissue deficit. The benefits of split and full thickness skin grafts, flap dimensions, and the impact of flat, convex or concave surfaces are brought out through clinical examples. The timing of post operative therapy and splinting, as well as the management of hypertrophic scar formation of the hand and upper extremity will be discussed. Presentation of severe burn deformities of joints and contracted soft tissue will permit discussion of advanced techniques of reconstruction including the use of tissue expanders placed below skin grafts to lengthen foreshortened tissue and tendons in long standing burn contracture.
Rehabilitative Period: Communication between hand therapist, surgeon, and members of the burn team play an important role in hand and extremity rehabilitation. Interaction in school and sports necessitates an education of a community not often familiar with the burn injury or the extent of limitations. The timing of smaller reconstructive procedures as well as the influence of growth on the scarred hand is discussed.
Summary: Reconstruction of the burned upper extremity in adults and children is presented through discussion and examples of the acute and reconstructive phases. Approach to reconstruction of the burned extremity requires attention to basic surgical principles and knowledge of scar contraction and maturation. Interaction of all involved in the care of the burned hand and upper extremity will provide insight into the proper timing of surgical reconstruction and the prognosis for return of maximum function.
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HS-IC21
Reconstruction Using Distal Sensory & Motor Nerve Transfers
Audience Level: Advanced
Chair: Susan E. Mackinnon, MD, St. Louis, MO
Faculty: Ida K. Fox, MD, St. Louis, MO; Christine B. Novak, PT, MS, Toronto, ON, Canada
Objectives:
• To understand the patient evaluation, timing and patient selection for nerve transfers in the hand and forearm
• To review the surgical reconstruction using nerve transfers for distal motor and sensory nerve injuries
• To understand the motor and sensory re-education strategies following nerve transfers
Description:
Following nerve injury, nerve transfers can provide a direct source of motor/sensory innervation at a more distal site closer to the end organ targets, thus providing faster recovery and maximizing motor and sensory outcome. This course will focus on the various surgical options for motor and sensory nerve transfers in the forearm and hand. The surgical reconstruction and postoperative rehabilitation for distal motor and sensory nerve injuries will be reviewed.
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HS-IC22
Dupuytren’s Disease: Past, Present, and Future
Audience Level: Basic
Chair: Marie A. Badalamente, PhD, Stony Brook, NY
Faculty: Lawrence C. Hurst, MD, Stony Brook, NY; Edward Akelman, MD, Providence, RI; Roy A. Meals, MD, Los Angeles, CA; Stephen G. Coleman, FRACS, Brisbane, Australia
Objective:
Participant should be able to discuss the history of Dupuytren’s disease and review the epidemiology, pathophysiology, and impact of this disease, understand the available options for treating patients with Dupuytren’s disease, including associated benefits and risks, and describe the mechanism of action and potential efficacy and safety of Clostridial collagenase for injection, a therapeutic agent under investigation for the treatment of patients with advanced Dupuytren’s disease.
Description:
In line with the theme of the 2009 Combined Annual Meeting of the ASSH & ASHT—Bridges: Connecting the Past and the Future—distinguished faculty from around the world will discuss the past, present, and future of Dupuytren’s disease during this symposium. The first presentation will review the history, epidemiology, and pathophysiology of Dupuytren’s disease, which is an ancient affliction that purportedly originated with the Vikings, who subsequently spread it throughout Europe and beyond as they traveled. Today, Dupuytren’s disease afflicts people of all races. However, its incidence is highest among people of northern European descent and is higher in men vs. women, diabetics vs non-diabetics, and elderly vs. younger people. Dupuytren’s disease is a progressive disorder of pathologic collagen deposition, the cause of which is not known. Genetics, trauma, diabetes, alcoholism, epilepsy, smoking, and liver disease have been hypothesized contributors. Dupuytren’s contracture is the end result of a disease process that has 3 phases: the proliferative phase, the involutional phase, and the final advanced or residual phase. Because of the development of contractures, patients with advanced Dupuytren’s disease have limited hand functionality that ultimately affects activities of daily living and quality of life. The second presentation will focus on the available treatment options for Dupuytren’s disease, including regional fasciectomy, fasciotomy, dermofasciectomy, and needle aponeurotomy. Clinical outcomes of these techniques, as well as reported complications, will be discussed.
The third presentation will introduce Clostridial collagenase for injection, which is a new, minimally invasive, non-surgical treatment option under investigation for patients with advanced Dupuytren’s disease. This presentation will review the mechanism of action of Clostridial collagenase, its administration procedure, including the injection and next-day manipulation techniques, and early clinical trial data. The final two presentations will describe the results of 2 randomized, placebo-controlled, double-blind, phase 3 pivotal trials—Collagenase Option for Reduction of Dupuytren’s (CORD) I and CORD II. CORD I was conducted at 16 centers in the United States and CORD II was conducted at 5 centers in Australia. In CORD I, 64.0% of joints treated with collagenase vs. 6.8% of placebo-treated joints (P<.001) met the primary end point (defined as reduction in contracture to 0°-5° of normal extension). Median time to achieve the primary end point was 56 days for collagenase-treated joints. Further, all 26 secondary end points met statistical significance (P<.002).
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HS-IC23
Elbow Arthroscopy: Indications, Techniques, Outcomes and Complications
Audience Level: Basic
Chair: Julie E. Adams, MD, Minneapolis, MN
Faculty: Scott P. Steinmann, MD, Rochester, MN; Graham J.W. King, MD, FRCSC, London, ON, Canada; Mark S. Cohen, MD, Chicago, IL
Objective:
Outline techniques for performing arthroscopic procedures at the elbow, with a specific focus on indications, technique, and outcomes. An emphasis will be placed on how to avoid potential complications. Upon completion of this course, attendees should be able to recognize indications and contraindications for elbow arthroscopy; be aware of pitfalls and complications; have familiarity with techniques and procedures of elbow arthroscopy for treatment of instability, osteoarthritis, rheumatoid arthritis, and tendonopathy about the elbow
Description:
Arthroscopy is increasingly becoming accepted as a treatment option for certain conditions about the elbow. Published studies have investigated the use of arthroscopy for rheumatoid arthritis and osteoarthritis, lateral epicondylitis, osteochondral defects, and instability. A review of current indications and contraindications, techniques and outcomes will be presented. Techniques to avoid complications will be discussed.
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HS-IC24
Flexor Tendon Injuries as Treated Around the World
Audience Level: Basic
Chair: Daniel P. Mass, MD, Chicago, IL
Faculty: David Elliot, MD; Mark Rider, MD; Krista Stoller, CHT; Jin Bo Tang, MD, Nantong, China
Objectives:
Designed to provide an update for surgeons and therapists on the latest research, surgical and therapy treatment protocols, and a look into the future for flexor tendon repairs
Description:
An international panel of speakers will present an update for both surgeons and therapists on the mechanics of flexor tendon repairs, how flexor tendons heal, current therapedic modes including active motion protocols, the results of modern techniques, and future research in enhancing tendon healing.
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HS-IC25
Kienböck’s Disease — What Have We Learned?
Audience Level: Intermediate
Chair: Peter Tang, MD, MPH, New York, NY
Faculty: Robert J. Strauch, MD, New York, NY; Melvin P. Rosenwasser, MD, New York, NY; Joseph E. Imbriglia, MD, Wexford, PA
Objectives:
• List the purported etiologies of Kienbock's disease
• Apply the classification system to a case radiograph
• Discuss the various treatment options
• Discuss the preferred treatment options of the panel members and their reasons for doing so
• Determine their own preferred method based the literature, case presentations, and the panel discussion
Description:
The purported etiologies and classification system of Kienbock's disease will be reviewed. For each stage of the disease, the various treatment options will be discussed along with the literature to support it, as well as an evaluation of the strength of the studies. Two younger members of the panel will discuss their thoughts on the etiology of the disease and their treatment algorithm. This will be followed by the two seasoned veterans discussing their opinions and approach. During these last two discussions, numerous case presentations from the panel members' practices will be reviewed.
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HS-IC26
Tendon Transfers for Upper Extremity Congenital Conditions: Indications, Techniques and Outcomes
Audience Level: Intermediate
Chair: Charles A. Goldfarb, MD, St. Louis, MO
Faculty: Michelle A. James, MD, Sacramento, CA; Ann E. Van Heest, MD, Minneapolis, MN;
Michael S. Bednar, MD, Maywood, IL; Pauline Ng, OTR/L, CHT, Sacramento, CA
Objectives:
• Understand the indications for and techniques of opposition transfer for the hypoplastic thumb
• Identify those patients with arthrogryposis, birth brachial plexus palsy, or other upper extremity disorders that will benefit from surgical intervention and tendon transfer
• Understand an appropriate therapy protocol after surgical intervention in these difficult cases
Description:
Each of the four surgeons will present a 12-15 minute didactic presentation on tendon transfers for upper extremity congenital or pediatric conditions, as listed below. The surgeon will focus specifically on the identification of those patients that will most likely benefit from surgical intervention, the surgical techniques that have stood the test of time with these conditions, and the realistic expectations after surgery. The therapist will discuss preferred protocols for the most common transfers. Video will be used to supplement the presentation when appropriate. Audience participation is welcome.
The areas for discussion will include
* Opposition transfers for the hypoplastic thumb (also applicable for the traumatic case)
* Elbow and wrist transfers in Arthrogryposis
* Shoulder and upper extremity in birth brachial plexus palsy
* Other congenital conditions, to include clasp thumb, cerebral palsy, tetraplegia, intrinsic transfers, etc.
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HS-IC27
Contemporary Perspectives of Complex Hand Fractures and Dislocations
Audience Level: Advanced
Chair: Jesse B. Jupiter, MD, Boston, MA
Faculty: Peter J. Stern, MD, Cincinnati, OH; Hill Hastings, II, MD, Indianapolis, IN; Diego L. Fernandez, MD, Bern, Switzerland; Carol Harmon Mahony, MS, OTR/L, CHT, Boston, MA
Objectives:
• Evaluate and treat complex pip fracture-dislocations
• Recognize factors in combined hand traumatic injuries
• Apply principles to treat malunion and nonunions
• Evaluate and treat complex fractures of the base of the thumb
• Apply principles of rehabilitation following complex hand trauma
Description:
The hand is subject to a wide variety of complex traumatic injuries involving not only the skeleton but also its articulations and surrounding soft tissue structures. It is imperative for all care providers to have an indepth understanding of the assessment of such injuries inorder to both classify the severity as well as treat appropriately.
This instructional course will address in depth a number of aspects of more complex traumatic injuries to the hand which involve as part of the injury a fracture or fracture-dislocation. The program will feature newer insights into the assessment, treatment, and rehabilitation of several complex injury patterns including proximal interphalangeal fracture-dislocations; articular fractures of the base of the thumb; combined skeletal and soft tissue injuries and complications post complex fractures including nonunion and malunion.
As part of the in depth discussions of each of these complex areas will be specific time dedicated to the specific rehabilitation challenges as well as recommendations regarding the most effective therapy modalities.
The program will be based upon a series of clinical cases upon which the panel will discuss their clinical insights and permit interactive discussion with those attending the course.
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HT-IC28
Model Instument for Outcome After Nerve Repair
Audience Level: Intermediate
Chair: Birgitta Rosén, OT, PhD, Malmo, Sweden
Description:
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 reorganisation 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 longed 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 but it is maybe 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 reinnervation of the hand. Each of these phases requires a specific treatment strategy, and sensory re-education should start immediately after nerve repair to preserve the cortical hand representation.
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HT-IC29
Know the Extensor Mechanism Inside Out: An Interactive Anatomy Review
Audience Level: Basic
Chair: Pat R. McKee, MSc, OT Reg. (Ont.), OT(C), Toronto, ON, Canada
Faculty: Anne Agur, PhD, MSc, BSc (OT), Toronto, ON, Canada
Objectives:
• Understand the detailed, three-dimensional anatomy of the extensor mechanism and intrinsic hand muscles, including the specific attachment sites
• Understand the function, biomechanics and innervation of the intrinsic muscles
• Understand common disorders of the extensor mechanism
Description:
Understanding the complex structure and function of the extensor mechanism and intrinsic muscles is important foundational knowledge for clinicians treating hand pathology.
Each participant will be guided through an educational experience, viewing videos of cadaveric dissected specimens in combination creating with 3-dimensional reconstruction of musculo-tendinous architecture beginning with the skeletal elements.
This unique, active learning, educational approach utilizes auditory, visual and kinesthetic senses to optimize comprehension of the complex structures, including the specific volar and dorsal attachments of the extensor mechanism and intrinsic muscles.
Extensor mechanism pathology, due to disease or injury, will be demonstrated with cadaveric specimens, 3-dimensional reconstruction and case presentations.
Thorough knowledge of the anatomy, biomechanics and function of the extensor mechanism is essential for both the therapist and the surgeon. It is only by understanding normal anatomy, that pathology can be understood and intervention can be judiciously planned.
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- HT-IC30
Multi-articulating Prosthetic Hands and Fingers
Audience Level: Intermediate
Part 1 of 2: Beyond Grasp
- Faculty: Laura Reed, CHT, PT, Middletown, NY; Sylvia Rogan, CHT, OT, Middletown, NY; Karl Lindborg, CP, Middletown, NY; Kim Doolan, BS, Middletown, NY
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- Objectives:
• Understand differences in available electric prosthetic hands
• Make clinical judgements regarding appropriate candidates
• Implement a functional pre and post prosthetic therapy program for an amputee wearing an electric prosthesis
• Gain knowledge of various grasp patterns of traditional and multi-articulating electric hands
• Know more about prosthetic choices for different amputation levels
Description:
This presentation will address progressive multi-articulating hand functions and will demonstrate the future path for increased patient acceptance of myoelectric devices and dispel myths about grip forces and cosmesis techniques. Comparisons will be made of the i-LIMB and Pro-Digits multi-articulating hand grasp patterns to currently available three-point pinch grasp patterns of Otto Bock and Utah hands.
Pre and post prosthetic functional training and advanced technology have increased patient acceptance of electric prostheses and decreased rejection rates.
While the progressive technical nature of electric prostheses will always interest the practitioner – this presentation will address the ways in which technology and traditional thinking are challenged by the experiences and ambitions of patients.
Part 2 of 2: Experience with Electric Prostheses for the Partial Hand Amputation Presentation – An Eighth year Retrospective
Faculty: Christopher Lake, CPO, Irving, TX; Robert Dodson, CPO, Irving, TX
Objective:
This presentation will provide detailed information regarding the design and application of electric partial hand prostheses for those patients presenting with partial hand amputations. Current and future trends relating to socket design, material sciences, surgical techniques, and technologic advancements in the development of electric partial hand prostheses will be addressed and discussed.
Description:
Limb deficiency distal to the wrist represents a common amputation presentation yet a difficult level to treat with a functional prosthesis. Historically, prosthetic treatment has been limited due to the lack of acceptable electric prosthetic options. As a result, individuals with partial hand amputation represent a patient population that has been previously underserved. As the specialty of upper limb prosthetics realizes the attention of many different research endeavors, advances in upper limb technology in the research laboratory begin to evolve toward commercial availability resulting in renewed interest in prosthetic treatment options at this amputation level.
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HT-IC31
Thumb CMC Osteoarthritis: It is Not Just About One Joint
Audience Level: Advanced
Chair: Judy C. Colditz, OT/L, CHT, FAOTA, Raleigh, NC
Objectives:
• Identify the unique anatomy of the three thumb joints
• Relate pathological patterns of pinch to joint anatomy
• Describe collapse patterns seen in patients with osteoarthritis of the thumb
• Evaluate all thumb joints and pathological pinch pattern when choosing splint designs
• Indentify multiple splinting options for thumb CMC osteoarthritis based on the pathological pattern of pinch
Description:
Do you sometimes feel you are missing something when treating a patient with CMC osteoarthritis? This instructional course will stimulate you to look at more than the CMC joint when pain at the CMC joint brings the patient to you. A brief review of the anatomy of the thumb joints provides a foundation for analyzing pathological pinch patterns, how they contribute to CMC joint pathology, and how to intervene with splinting. The climax of the session will be a live evaluation (video projection) of the thumbs of 3-4 participants with suggestions for intervention and especially splinting.
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HT-IC32
Management and Rehabilitation of Distal Radius Fractures: What is the Evidence?
Audience Level: Basic
Chair: Nancy Wesolowski, OTD, OTR/L, CHT, Scranton, PA
Faculty: Tambra Marik, OTD,OTR/L, CHT, Gig Harbor, WA
Objectives:
• Discuss the general anatomy and types of distal radius fractures
• Describe the evolution of fixation devices for distal radius fractures and the trend for plate fixation as based upon the evidence in the literature
• Apply recommendations for current therapeutic interventions and time frames for distal radius fractures as based upon current literature
• Define precautions and “red flags” associated with the treatment of distal radius fractures
Description:
The intent of this instructional course is to provide an evidence-based literature review on surgical and rehabilitative management of distal radius fractures.
The proposed instructional course will present a general anatomical and kinetic review of the wrist based on scientific research. Types of distal radius fractures and how they impact the ulna, distal radial-ulna joint, carpals, and soft tissue structures which can be involved with fractures of the distal radius will also be discussed. This course will review the evolution and application of internal and external fixation devices to assist hand therapists with fracture management based on the scientific research.
This course will review assessments of distal radius fractures for appropriate treatment management. Recommendations for treatment will include splinting, edema management, range of motion, strengthening progressions, and precautions as it applies to hand therapists. A general hand therapy paradigm will be presented and include specific time frames and intervention techniques based on the current literature.
The importance of patient-centered outcome measures will be reviewed. This course will discuss the appropriate outcomes that are reliable,valid,and responsive for patients with distal radius fractures.
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HT-IC33
Part II: Management of Upper Extremity War Zone Injuries — Polytrauma
Audience Level: Intermediate
Moderator: Sarah B. Goldman PhD, OTR/L, CHT, Natick, MA
Faculty: MAJ Matthew G. St. Laurent, MS, OTR/L, CHT, Washington, DC; MAJ Charles Quick, MS, OTR/L, El Paso, TX; LTC Martin J. Baechler, MD, Washington, DC
Objectives:
• Identify the common upper extremity injuries associated with war
• Understand treatment principles of wartime polytrauma through case presentations
Description:
Successive military conflicts have historically advanced surgical and rehabilitative treatment of upper extremity injuries. Improved surgical techniques, more effective rehabilitation strategies, and advances in medical technology have improved the functional outcomes of those afflicted by the atrocities of war. Practitioners in both the civilian and military sectors are involved with the rehabilitation of these individuals across the continuum of care.
Part II of this instructional course will cover treatment of complex upper extremity polytrauma sustained during present-day war. Speakers will present unique case studies of upper extremity polytrauma, highlighting surgical management and rehabilitation principles.
Speakers will consist of hand surgeons, hand therapists, and prosthetists (for the amputee course) who have experience in a variety of military settings, from Combat Support Hospitals on the front lines to large Military Treatment Facilities in the United States.
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