Surgeon Track
Therapist Track
11:15 AM - 12:45 PM
HT-ICNM
Under the Skin: Reading and Interpreting X-rays
Audience Level: Intermediate
Chair: Sandra Harrison-Weaver, MHE, OTR/L, CHT, Washington, DC
Objectives:
• Identify 3 reasons for viewing x-rays
• Identify common radiologic views of the upper extremity
• Differentiate immature from mature skeletal features
• Accurately describe a fracture seen on x-ray using appropriate terminology
• Identify common radiologic abnormalities of the upper extremity and discuss the impact of those findings on OT treatment
Description:
This dynamic and interactive instructional course program is presented in power point format and takes the particpant through the basics of radiography of the upper extremity to the complexities of identifying abnormalities on actual x-rays. Participants are guided through the process of identifying normal characteristics and features of x-rays of the shoulder, elbow, forearm, wrist, hand and digits in the first 2-hour section. Then, particpants are challenged to identify abnormal findings on x-rays of the upper extremity for the second 2 hours of the course. Pre- and post-surgical films are included. Implications of abnormal findings on OT treatment are discussed. Throughout this 4-hour instructional course, participants are asked to identify normal and abnormal positions, joint spaces, alignment, densities, fractures, etc. Participants will walk away with a better understanding of radiography of the upper extemity and increased confidence in their ability to identify the impact of radiographic abnormalities on occupational therapy treatment.
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4:30 - 6:00 PM
HS-IC01
Current Practice in Scapholunate Ligament Injuries
Audience Level: Intermediate
Chair: Charles S. Day, MD, Boston, MA;
Faculty: Charles A. Goldfarb, MD, Saint Louis, MO; Alexander Y. Shin, MD, Rochester, MN; Lana Kang, New York, NY
- Objectives:
• Understand the literature and evidence behind different repair techniques
- • Understand the treatment algorithm of the hand surgeons at the Mayo Clinic
- • Understand the treatment algorithm of the hand surgeons at the Wash. U., St. Louis
- • Understand the treatment algorithm of the hand surgeons at the Hospital for Special Surgery
- • Understand the treatment algorithm of the hand surgeons at the combined Harvard programs
Description:
Scapholunate ligament instability occurs over a range of categories. The most common characteristics used to identify scapholunate injuries (prior to advancement to degenerative stages) include chronicity, radiographic presentation, and degree of stability. Chronicity is often divided into acute, subacute, and chronic (also referred to as late or established) categories (1). Scapholunate dissociation is further categorized as static or dynamic, based on radiographic presentation. Static dissociation refers to abnormal wrist radiographs, while dynamic dissociation refers to cases with normal standard radiographs diagnoses made based on clinical examination and stress radiographs (positive Watson test), or diagnostic arthroscopy.
A review of the literature on scapholunate treatment outcomes over the last ten years reveals a lack of true evidence-based studies. Approximately 20 articles have been published examining the clinical outcomes of various treatment options for the various categories of scaphlunate ligament injuries. Nearly all studies were level IV design, except one level III study retrospectively comparing a modified Brunelli technique with a 4-bone tendon weave in patients with chronic scapholunate dissociation (2). Due to the retrospective nature of most of the studies, the results of the outcome measures for many of the treatment options are difficult to reproduce in actual practice.
Although scapholunate injuries represent the most common cause of carpal instability, there is a clear lack of evidence-based outcome measures for the treatment options. The purpose of this instructional course lecture is to invite representative speakers from four institutions in the United States performing hand surgery to discuss how different stages of scapholunate ligament injuries are currently being managed. Four cases in particular, occult (partial SLIL), dynamic SLIL, scapholunate dissociation (complete SLIL), and DISI deformities (complete SLIL with secondary changes), will be addressed by the speakers. Additionally, the speakers from the different institutions will solicit all hand surgeons at their respective institutions to discuss how these categories of scapholunate injuries are being managed, and how confident each surgeon feels about the success rate of each of the treatment options in his or her practice. Each surgeon will specifically address success rate as measured by symptomatic pain, radiographic scapholunate gap, restoration of function, progression of disease, and patient satisfaction. With this multi-institutional effort, this course lecture aims to help guide current surgical practice in light of a dearth of evidence-based outcome measures.
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HS-IC02
Reconstruction of Elbow Flexion
Audience Level: Basic
Chair: Milan V. Stevanovic, MD, Los Angeles, CA
Faculty: Robin R. Richards, MD, Toronto, ON, Canada; Allen T. Bishop, MD, Rochester, MN; Christophe Oberlin, MD, Paris, France; Frances E. Sharpe, MD, Fontana, CA
Objective:
The goal of the symposium is to provide attendees with various options and detailed surgical technique for the restoration of elbow flexion
Description:
The panel will review the pertinent anatomy of the elbow and associated muscles for reconstruction. Panelists with extensive experience in each technique will present their indications, surgical technique and outcomes for restoration of elbow flexion.
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HS-IC03
Unusual Neurologic Conditions in Hand Surgery: Not Your Typical Carpal Tunnel Syndrome
Audience Level: Intermediate
Chair: Robert J. Strauch, MD, New York, NY
Faculty: Richard Y. Kim, MD, Upper Montclair, NJ; Donald H. Lee, MD, Nashville, TN
Objectives:
• Describe the anatomy and pathophysiology of common upper extremity neuropathies
• Recognize unusual neurologic conditions affecting the hand and upper extremity that can be confused with the more common surgically remediable conditions. Parsonage Turner Syndrome, ALS, CIDP, HPPN among other entities will be discussed as they relate to the upper extremity
• Demonstrate how to screen for and appropriately refer unusual neurologic conditions
Description:
While carpal and cubital tunnel syndrome are the most commonly seen compressive neuropathies of the upper extremity, a busy hand surgeon will most likely encounter some of the more unusual neurologic conditions of the upper extremity. These conditions are easily overlooked, and if unrecognized may result in unsuccessful surgical outcomes. This instructional course is designed to aid the audience in the recognition of these conditions. Parsonage Turner Syndrome, ALS, CIDP, HPPN, among other entities will be discussed as they relate to the upper extremity.
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HS-IC04
The Assessment and Management of Nerve Dysfunction Associated with Upper Limb Fracture
Audience Level: Basic
Chair: Jesse B. Jupiter, MD, Boston, MA
Faculty: Susan E. Mackinnon, MD, St. Louis, MO; David C. Ring, MD, Boston, MA; L. Andrew Koman, MD, Winston-Salem, NC; Coleen T. Lowe, OTR/MPH/CHT, Boston, MA
Objectives:
• Describe classification of nerve dysfunction following fracture
• Discuss the management of radial nerve palsy post humerus fracture
• Analyze ulnar nerve dysfunction associated with elboe traumatic injuries
• Recognize and treat median and ulnar nerve injury with wrist trauma
• Recognize and treat complex regional pain associated with nerve injury and fracture
Description:
The hand and uppper limb surgeon will be called to provide assessment and management decisions regarding nerve dysfunction associated with upper limb fractures or dislocations. He/She will be required to assess the type of nerve injury, whether or not adjuvant testing will be required, and the indications and timing for surgical intervention. In addition, when faced with direct nerve injury, decisions will be required as to timing of treatment, neurolysis, or nerve grafting. This instructional course will feature evidence-based discussion regarding a number of key nerve injuries.
Radial nerve dysfunction associated with humeral shaft fractures continues to evoke some controversy as to optimal treatment. The timing of electrophysiologic testing, appropriate hand splinting, the indications for surgery, as well as surgical exposures will be featured in this case-based instructional course. The decisions regarding primary neurorraphy versus delayed grafting will be discussed.
Ulnar nerve dysfunction may be the more disabling outcome of elbow trauma and surgical interventions. The management of the ulnar nerve during surgery, whether or not transposition should be done, and appropriate hand therapy modalities be highlighted.
At the wrist both median and ulnar nerve injury have been commonly noted and the decision as to management as to when to pursue surgical intervention, the indications and techniques of nerve release in association of internal fixation, and the assessment and management of complex regional pain associated with these nerve injuries will be a topic of thorough discussion.
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HS-IC05
Diagnosis and Current Treatment of Chronic Injuries of the Distal Radioulnar Joint
Audience Level: Intermediate
Chair: William P. Cooney, III, MD, Rochester, MN
Faculty: Marc Garcia-Elias, MD, Barcelona, Spain; Richard A. Berger, MD, PhD, Rochester, MN;
Peter M. Murray, MD, Jacksonville, FL
Objectives:
• Define accurate methods to identify and stratiefy treatment of chronic injuries of the DRUJ
• Review current diagnositic and imaging to classify DRUJ injuries
• Describe an algorthym for advancing treatment
• Compare resection vs joint arthroplasty for treatment of arthrtis of the DRUJ
• Review and update outcome measures following treatement of the DRUJ
Description:
Instability and arthritis of the DRUJ remains challenging. Ligament reconstruction, resection arthroplasty with soft tissue repair, partial distal ulna replacement and complete ulna head arthroplasty will be presented with an algorythm for diagnosis and treatment of disorders of the DRUJ. Specific surgical techniques will be described in detail and comparison of results between these treatment modalities including objective wrist scores and patient assessment tools ( DASH, PRWE) will allow participants to critically review current treatment considerations. Anticipated complications and resolution of outcomes are described with emphasis on salvage of unsuccessful results. Panel discussion of complex cases will be presented.
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HS-IC06
Scaphoid Fractures and Nonunions: The Devil is in the Details
Audience Level: Basic
Chair: David J. Slutsky, MD, Torrance, CA
Faculty: Randip R. Bindra, MD, Maywood, IL; Joseph F. Slade, III, MD, Guildford, CT; Alexander Y. Shin, MD, Rochester, MN; Amit Gupta, MD, FRCS, Louisville, KY; William B. Geissler, MD, Jackson, MS; Christophe L. Mathoulin, MD, Paris, France
Objective:
This symposia highlights the indications, complications, pearls and pitfalls of scaphoid screw fixation for acute fractures and nonunions with and without AVN
Description:
There has been an evolution in scaphoid screw fixation with an explosion of new implants and techniques. When to screw, when to pin and when to graft are constant considerations. Open, mini-open, percutaneous and arthroscopic techniques are now commonplace as are a variety of volar and dorsal vascularized grafts. This symposia highlights the indications, complications, trial and tribulations of scaphoid screw fixation for acute fractures and nonunion reconstruction and is intended for the novice and the expert both. The information will be presented as short didactic talks intermingled with powerpoint slides and video case examples.
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- HS-IC07
- 10 in a Row: Experts Results of 10 Consecutive Distal Radius Fracture Cases, as Judged by Their Peers
Audience Level: Intermediate
Chair: Matthew D. Putnam, MD, Minneapolis, MN
Faculty: Melvin P. Rosenwasser, MD, New York, NY; Robert J. Strauch, MD, New York, NY; Rick F. Papandrea, MD, Waukesha, WI
Objectives:
• Reliably differentiate A, B, and C type Distal Radius Fractures
• Re-iterate and apply instability criteria to the fracture types discussed
• Discuss frequency and management of adverse events
• Discuss expected speed of recovery after DRFX
• Apply basic outcome measurement principles to evaluating personel/practice success in treating DRFX
Description:
What do the "experts" really do?
This instructional course will pit 4 "experts" against one another in a race to achieve the fastest recovery and fewest adverse events in a consecutive series of 10 distal radius fractures.
Participants will see the fracture types and treatment rendered in the course of the faculties routine practice.
The faculty will review and critique each others cases with time allowed for each faculty member to defend their choice of treatment. Audience involvement will be encouraged after reviewing each "expert's cases. Specific emphasis will be placed on common treatment principles, maximizing recovery speed, and adverse event reduction.
The outcomes principles used to design this course and measurement methodology will be explained.
Participants will receive a handout summarizing the individual cases treated detailing the cases analyzed.
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HS-IC08
Treatment of the Other Arthridities: Scleroderma, Psoriasis, Gout, CPPD and HADD
Audience Level: Intermediate
Chair: A. Lee Osterman, MD, King of Prussia, PA
Faculty: Paul Feldon, MD, Boston, MA; David S. Zelouf, MD, King of Prussia, PA; Terri Skirven, CHT,OTR, Philadelphia, PA
Objectives:
• Recognize the hand and wrist manifestations of the various arthritic conditions
• Understand the specific pathophysiology of the deformities related to these conditions
• Define a treatment strategy of these conditions
• Avoid the pitfalls inherent in caring for such conditions
Description:
Better medical control of rheumatoid arthritis and SLE has lessened the need for hand surgery care. By contrast, the incidence of other arthritic conditions requiring hand surgery intervention has become more frequent . This course will address the diagnostic and therapeutic strategies necessary to treat the conditions of scleroderma, crystalline deposition disorders, and psoriasis .
The pathophysiology of scleroderma leads to progressive MCPJ and PIPJ contractures, CREST, and often vascular insufficiency. The crystalline disorders- Gout, Calcium Pyrophosphate Disease and Hydroxyapatite deposition – often are misdiagnosed as infection and present specific treatment dilemmas at the wrist and in the small joints. Psoriasis results in absorptive arthropathy and tenosynovities. Many of these conditions are associated with peripheral nerve compression such as cubital and carpal tunnel syndromes. This course will update the role of nonoperative treatment as well as the indications and techniques of joint replacement, fusions, tenosynovectomy, arthroscopic synovectomy, and digital sympathectomy. The role of hand therapy will be discussed.
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HS-IC09
Operative Fixation of Pediatric Hand and Upper Extremity Fractures — How I Do It!
Audience Level: Intermediate
Chair: Scott H. Kozin, MD, Philadelphia, PA
Faculty: Donald S. Bae, MD, Boston, MA; Peter M. Waters, MD, Boston, MA
Objectives:
• List pediatric upper extremity fractures that require fixation
• Recognize fracture patterns of the pediatric upper extremity
• Apply principles of fracture fixation to the pediatric upper extremity
• Assess fracture reduction via clinical and radiologic criteria
• Analyze expected ouitcomes following pediatric upper extremity fractures
Description:
More and more pediatric upper extremity fractures are being managed by operative fixation. The indications for surgery, implants available, and patient/ family expectations have all increased. The goal of this instructional course lecture (ICL) is to provide current practice recommendations for fixation of pediatric upper extremity fractures and to offer technical pearls to maximize success. Case presentations will be used to highlight many of the salient points and to encourage audience participation.
The ICL will work from distal to proximal, beginning at the digits and ending at the elbow. The finger section will include extra-articular and intra- articular fracture types with an emphasis on early recognition, operative management, and restoration of articular congruity. The wrist discussion will cover isolated carpal injuries and perilunate fracture dislocations. The differences between adult and children treatment algorithms will be highlighted.
The forearm portion will focus on both bone forearm fractures with a discussion concerning the controversy of one bone intramedullary fixation versus two bone intramedullary fixation versus plate and screws fixation. Galeazzi injuries will also be reviewed with current recommendations to achieve and maintain radial head reduction in late cases. The elbow section will focus on lateral condyle, medial epicondyle, and supracondylar fractures. The indications for fracture fixation will be discussed and a treatment algorithm for the avascular hand after supracondylar fracture presented.
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HS-IC10
Shoulder Reconstruction Options for Patients with Brachial Plexus Injury
Audience Level: Intermediate
Chair: Bassem T. Elhassan, MD, Rochester, MN
Faculty: Allen T. Bishop, MD, Rochester, MN; Kai-Nan An, PHD, Rochester, MN; Jon Warner, MD, Boston, MA
Objectives:
• Perform a Comprehensive Examination of the Shoulder in Brachial Plexus Patients
• Analyze and Understand the Shoulder Functions that Need to be Restored
• Define Functional Remnant Muscles Around the Shoulder that Could be Used for Transfer and Make the Appropriate Plan
• Recognize the Presence of Newer, and Novel Alternatives of Tendon Transfers that Can Improve Shoulder Function
• Apply the New Alternative Tendon Transfers in their Brachial Plexus Practice
Description:
Persistent shoulder dysfunction after brachial plexus injury and/or reconstruction is a very disabling problem. Nerve transfers often fail to improve the involved shoulder function, especially in complete brachial plexus injury. In this case or when patients presented later after their injury with persistent shoulder paralysis, alternative surgical options can be attempted to try to improve the shoulder function. These options may include shoulder fusion which stabilizes the shoulder and allows some limited shoulder motion through the scapulothoracic articulation, or attempt at free vascularized muscle transfers, pedicled muscle transfer, or local muscle transfers to try to maintain the combined glenohumeral and scapulothoracic articulation.
When tendon transfers are planned, in order to achieve better outcome, understanding basic biomechanics of the shoulder in relation to the rotator cuff and deltoid is essential. The rotator cuffs are not only the prime rotators of the shoulder, but they are also the main muscles that depress the humeral head and maintain it on the surface of the glenoid. This creates a fulcrum that facilitates the deltoid function and maintain its moment arm for maximum performance. Thus, attempt at restoration of partial or complete rotator cuff functions should be the first step in the reconstruction ladder of the shoulder, followed by the deltoid.
Among all shoulder functions, the most critical function is shoulder external rotation, followed by flexion and then abduction. The importance of shoulder external rotation is appreciated on examining most patients who either have elbow flexion or regained elbow flexion after reconstructive surgeries. These patients might be able to flex their elbow, however, while they are performing this motion their forearm rubs on their abdomen and chest because they can't externally rotate the shoulder to position the hand in front of their body to perform their usual activities.
A novel lower trapezius transfer has been performed recently to restore external rotation with very promising results. Other types of transfers include: upper and middle trapezius muscle transfers, levator scapulae transfer, upper serratus transfer, pectoralis major transfer, and latissimus and/or Teres major transfers.
The improved shoulder function outcome with the new single or multiple tendon transfers may open a new horizon in the management of brachial plexus patients. This may shift the gear towards preserving essential available functioning muscles, like the trapezius muscle, by trying to avoid using the spinal accessory nerve for nerve transfer.
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HT-IC11
Take the Passage Between Detecting Faulty Shoulder Girdle Movement to Corrective Exercise Prescription
Audience Level: Intermediate
Chair: Tambra Marik, OTD, OTR/L, CHT; Gig Harbor, WA
Faculty: Kris Valdes, OTD, OTR/L, CHT
Objectives:
• Analyze patient’s glenohumeral and scapulothoracic movement for functional versus faulty movement patterns as defined by biomechanical studies
• Evaluate shoulder girdle posture and movement patterns to prescribe a skilled and personalized exercise prescription
• Apply patient specific exercise prescription supplemented by EMG muscular studies to decrease pain, restore muscle balance, and improve range of motion
• Assess pectoralis minor, scapulohumeral, thoracohumeral, and axioscapular muscle imbalances to recognize musculoskeletal relationships to faulty shoulder girdle biomechanics
• Recognize specific scapular and humeral faulty movement patterns to include scapular depression, scapular downward rotation, humeral anterior glide, humeral superior glide, shoulder medial rotation, glenohumeral hypomobility
Description:
Hand therapists are skilled experts within the upper quadrant muscle functions, posture, and biomechanics. This course is designed to strengthen hand therapist’s assessment and treatment skills when addressing musculoskeletal shoulder girdle pain. Participants of this course will learn to assess the relationship of shoulder pain related to muscle imbalances and faulty scapulohumeral rhythm. Discussion of muscular length associations of pectoralis minor, scapulohumeral muscles and thoracohumeral muscles will be emphasized to assist therapists with detecting faulty shoulder girdle movement patterns. The force couples and biomechanics of the scapulothoracic joint, glenohumeral joint, and clavicular joints will be reviewed to enhance therapist’s evaluation and treatment skills when assessing faulty musculoskeletal movement patterns. There will be an in depth discussion on humeral movement impairments to include: humeral anterior glide, humeral superior glide, shoulder medial rotation, and glenohumeral hypomobility. A detailed discussion of both, humeral and scapular movement impairments will be addressed to provide hand therapists with a clear understanding of the musculoskeletal connections within the upper quadrant kinetic chain. Therapists attending this course will learn to identify upper quadrant muscular length and strength associations that contribute to faulty movement impairments. This course will recommend exercise prescriptions based on EMG studies and supplemented with theoretical concepts of Shirley Sharmann and Florence Kendall. Hand therapists will complete this course with skills to assess shoulder girdle alignment, movement patterns, muscle length and strength. Additionally, hand therapists will have the capability to apply the skills learned from this course for exercise prescription to correct faulty movement patterns relating to impingement, thoracic outlet syndrome, rotator cuff tear, humeral subluxation, acromioclavicular pain, bursitis, and early stage adhesive capsulitis.
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HT-IC12
Canadian Occupational Performance Measure as an Outcome Measure in Hand Therapy Practice
Audience Level: Intermediate
Chair: Mary Law, PhD, FCAOT, FCAHS, Hamilton, ON, Canada
Objectives:
• To learn about the development of the COPM
• To learn about the psychometric properties of the COPM
• To develop skills in applying the COPM to assessment in hand and upper limb therapy practice
Description:
The workshop will be on the Canadian Occupational Performance Measure and will provide an overview of the COPM, teach people how to conduct a COPM interview and use the COPM as an outcome measure in hand therapy practice. Research relevant to the COPM in hand therapy practice will be highlighted.
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HT-IC13
The Unstable Elbow — A Broken Bridge between the Shoulder and Hand
Audience Level: Intermediate
Chair: Mike L. Szekeres, OT Reg (Ont.), London, ON, Canada
Faculty: Graham J.W. King, MD, MSc, FRCSC, London, ON, Canada
Objectives:
• Recognize the important anatomical structures of the elbow that contribute to elbow stability
• Discuss surgical decision making for ligament repair and reconstruction for lateral and medial collateral ligament injury
• Describe the progression of ligament injury and instability of the elbow during trauma
• Identify the common techniques for rehabilitation
• Use clinical decision making to progress elbow rehabilitation for unstable elbows using biomechanical rationale
Description:
This instructional course will cover both the surgical and rehabilitative aspects of elbow instability. A detailed review of the anatomical structures that contribute to elbow stability will introduce the course. The instructing surgeon will then introduce the surgical techniques and decision making used to repair and/or reconstruct ligamentous injuries to the elbow. Following each type of ligamentous injury, the instructing therapist will review the common rehabilitation techniques used for initial post-operative management. Concepts covered will include splint positioning, protected range of motion, edema control, and functional hand use.
The next phase of the instructional course will involve presentation of selected problem cases to ensure audience understands the concepts outlined above. Both the instructing surgeon and therapist will encourage audience participation and will focus on clinical decision making for "hot issues" such as surgical approach, immobilization time, passive stretching, and timing static progressive splinting to regain motion.
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HT-IC14
Multidisciplinary Management Strategies for Brachial Plexus Birth Injuries
Audience Level: Advanced
Chair: John A.I. Grossman, MD, FACS, Miami, FL
Faculty: David Ruchelsman, MD, New York, NY; Andrew Price, MD, New York, NY; Lorna Ramos, MA, OTR/L, Miami, FL
Objectives:
• Evaluate and diagnose an infant with a possible brachial palsy
• Analyze therapeutic options in infants and older children
• Apply an appropriate course of rehabilitation for different levels of injury in different age groups
Description:
This program will present a multidisciplinary approach to the management of the child with a brachial plexus birth injury. The integrated role of the hand and peripheral nerve surgeon, pediatric orthopedic surgeon, and hand therapist in the diagnosis and long-term treatment of these children will be detailed. The course will use didactic lectures and case presentations supplemented by videos of techniques and results.
Major areas covered will include techniques for clinical examination of the infant, uses for imaging and neurophysiology, rehabilitation modalities, surgical decision making, late treatment options and outcomes.
The program is similar to that presented to American Society for Surgery of the Hand (ASSH) at the annual meeting in Washington DC in 2006, but with greater emphasis on hand therapy.
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HT-IC15
Wound Care: Bridging the Past and the Future with Evidence- based Wound and Tissue Management
Audience Level: Intermediate
Chair: Gaylene Branstiter, MEd, OTR/L, CHT, London, ON, Canada
Objectives:
• Describe the cellular and process changes influencing each stage of wound and tissue healing
• Identify wound types including granulating, epithelialising, infected, sloughy, cellulitic and necrotic
• Evaluate wounds and recognize the best dressing choice for each wound
• Apply clinical reasoning and evidence to wound and tissue management decisions
• Discuss the past vs. the future and current research condcuted within the field of wound and tissue management
Description:
The wound and tissue healing process is a complex series of events that begins at the moment of injury and continues for months to years. Learn more about this fascinating process and refine your skills of clinical reasoning and application to the wound and tissue management of Hand Therapy patients. Within this session we will disucss the cellular processes of wound and tissue healing at all stages, view healthy and infected wounds, review the wide array of wound dressings and how we can choose the optimal one for each type of wound. Comparison of differential healing between skin, tendons, ligaments and bone will be discussed. We will review the past, current concepts and research as it applies to wounds and tissue management. Evidence in literature for various wound and tissue treatments will be presented. As clinicians we can holistically assess, treat,and communicate our treatment choices while fully impacting our patient in this critical area of care.
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HT-IC16
Part I: Management of Upper Extremity War Zone Injuries—Amputee Care
Audience Level: Intermediate
Moderator: William J. Howard, OTR, MA, CHT, Ft. Sam, Houston, TX
Faculty: LTC Gerald L. Farber, MD, Honolulu, HI; CPT Sarah A. Mitsch, OTR/L, Washington, DC; Ryan P. Spill, CP, Redondo Beach, CA
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 I of this instructional course will highlight the management of upper extremity amputations throughtout the contunum of care. The speakers will present unique case studies of upper extremity amputations sustained during combat operations.
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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