Instructional Courses

Instructional Courses are included in standard registration fees and are daily concurrent sessions. Brief descriptions are posted here, click to view  full descriptions with faculty listed.

CME Available

Refer to session information for specific CME details. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Schedule of Instructional Courses
Thursday Instructional Courses Friday Instructional Courses Saturday Instructional Courses
The functional role of the distal radioulnar joint in upper extremity function is undergoing greater appreciation.  The kinesiology of the joint and surgical options for either traumatic or inflammatory conditions has expanded with the development of hemi, total or constrained arthroplasties.  This course will feature detailed descriptions of the indications, applications and outcomes based on evidence-based literature as well as the experience of a panel of international experts.
Since the advent of volar plating, the management of distal radius fractures has evolved.  There are circumstances, however, where its use is not advocated or sufficient to achieve fracture reduction and fixation.  The goal of the instructional course lecture is to present the audience with an overview in the management of comminuted intra-articular distal radius fractures.  The role of volar plating, fragment specific fixation, distraction plating, external fixation and management of associated injuries will be discussed with an emphasis on technical pearls to achieve fixation of these difficult injuries.  The faculty will present various cases for panel and audience discussion.
Supermicrosurgery is the advanced branch of microsurgery handling and operating very small vessels, nerves and lymphatic ducts (diameter ranging from 0.1 to 0.5mm).  Its clinical applications have brought many advantages to us.  This course will present practical knowledge and techniques of supermicrosurgey for hand reconstruction.
This course focuses on elbow arthroscopy from “simple to complex.”  The basics of elbow arthroscopy will be explored, including indications, techniques, setup and portals.  A focus on techniques to avoid complications will be made.  Discussion will be held regarding advanced procedures that are expanding and pushing the limits of arthroscopic surgery.  Finally, procedures or situations that are better served by procedures other than arthroscopy will be explored.  Case based discussion and audience participation and interaction will be highlighted in this instructional course lecture.
The current management following brachial plexus injury is a changing paradigm.  Motor nerve transfers can provide a direct source of muscle innervation at a site distal to the brachial plexus and closer to the end organ targets, thus providing faster recovery and maximizing patient outcome.  However, this new motor reinnervation and muscle function may also set the foundation and provide opportunities for future muscle and tendon reconstructions, for example in lower brachial plexus injuries.  This course will focus on the current surgical options using motor and sensory nerve transfers for reconstruction following upper (C5,C6 ± C7) and lower (C8,T1 ± C7) brachial plexus nerve injuries and provide a systematic approach to surgical decision making.  The evaluation, timing, patient selection, surgical reconstruction, postoperative rehabilitation and outcomes using nerve transfers for complex brachial plexus injuries will be reviewed.  This course will be directly applicable to the brachial plexus surgeons in addition to surgeons treating major nerves in the upper extremity.
This course will address several current controversies in pediatric hand surgery in a debate-style format.  Each topic will be addressed by two experts, who will have five minutes each to argue their side of the controversy. This will be followed by 1-2 illustrative cases of each condition with active audience participation.
WALANT (Wide Awake Local Anesthesia No Tourniquet) means the deletion of the tourniquet, sedation and narcotics by injection of lidocaine and epinephrine everywhere the surgeon will dissect for hemostasis and pain control.  Tips on almost pain free local anesthetic injection will be provided.  Patient satisfaction and convenience can be enhanced because simple procedures like carpal tunnel release become more like a visit to the dentist.  They don't need preoperative testing, and they don't get nausea and vomiting.  Surgeons get to watch comfortable patients actively move reconstructed structures such as repaired flexor tendons and tendon transfers before closing the skin.  Surgeons can also work independently without anesthesia providers.  Tips on how to work with your hospital/surgicenter to introduce this method will be provided.
PIP injuries and arthritis can be vexing problems for the hand surgeon.  PIP motion is paramount to hand function, yet is often lost in trauma and arthritis.  Developments in fracture treatment and arthroplasty have armed the hand surgeon with more options to restore mobility, relieve pain and return to functional activities.  Which treatment to choose and why will be discussed as well as what to do when primary treatment choices fail.  This will be a case based course concentrating on a combination of the panelists’ experience and available literature.  Participants will be able to submit cases beforehand to be discussed in an open format in the second half of the session.
This course will discuss the indications, screening and selection, planning and surgical execution of a hand and/or upper limb transplant (including hand/limb donation) as well as immunological management for the performance of hand and upper limb transplantation.  This will include transplantation extending from the radiocarpal to the trans-humeral level.  The panelists will break down this large topic into an introduction followed by four sections including patient screening and selection, pre-operative planning, surgical execution and immunological management.
Communication with our patients is something we rarely think about when the patient care process is going smoothly.  However, our interactions with patients can be more important than the treatment we ultimately render.  It influences our patients’ outcomes, our professional satisfaction and, given the initiatives to link provider payment to patient satisfaction scores, our bottom lines.
All hand surgeons are well versed in the management of peripheral nerve compression and peripheral nerve injuries.  Carpal tunnel release, cubital tunnel release and peripheral nerve repairs are among the most common procedures performed by hand surgeons.  Overall, high success rates are reported for the management of these common conditions; however, failures still occur and revisions are necessary at times.  Surprisingly, there is a paucity of literature and guidance for the management of failed primary peripheral nerve surgery.
This course will discuss current diagnosis, treatment controversies and rehabilitation of these challenging sports elbow injuries including osteochondritis dessicans of the capitellum, acute and chronic medial apophyseal injury and other “thrower’s” maladies.  Special attention will be paid to avoiding pitfalls in diagnosis and treatment, rehabilitation protocols and prognosis for return to sport.  Audience members are encouraged to submit difficult cases ahead of time for panel discussion.
In order to enhance the relevance of the course, experts will describe their considerable experience with selected injuries and how their care delivery and plans for resuming competition vary in the scholastic, collegian and professional high-performance athlete.  Historical "winners and losers" are identified, so the audience can benefit from the longevity of experience of the panelists.
The ACGME Next Accreditation System (NAS) began phased implementation in July 2013.  A primary focus of the NAS is documented, competency-based education and accreditation on the basis of educational outcomes.  The Milestone Project was implemented for Orthopaedic Surgery in July 2013 and will be implemented for Plastic Surgery and all orthopaedic and plastic hand surgery fellowships in July 2014.  Many members have questions about using and documenting the Milestones and how they can introduce or augment competency-based education.  Faculty of this course will explain important changes in the NAS, including ACGME Milestones.  The rationale for Milestones will be presented as well as an overview and demonstration of how to use and evaluate Milestones.  In this Instructional Course, the faculty will also address the need for surgical simulation and demonstrate how to develop and implement a successful surgical simulation program.  Actual teaching exercises and pearls will be shared that will facilitate success in your own program.
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.

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© 2014 American Society for Surgery of the Hand