The Smashed Elbow will discuss new techniques for addressing the most common fractures of the elbow. Attention will be directed at surgical steps to allow for ideal fixation. The complications that may occur as well as the current state of postoperative management will be discussed.

Objectives: Following this session, the participant will be able to:

1. Understand the most common fracture patterns in the elbow.
2. Learn surgical approaches to coronoid, distal humerus and radius fractures.
3. Recognize the instability patterns in association with fractures.
4. Learn complications that might occur and how to avoid them.
5. Recognize solutions to achieving optimal outcomes

Formulating a diagnosis and treatment plan for the patient with ulnar sided wrist pain can be challenging. This instructional course will help the participant categorize and organize the differential diagnosis by presenting an algorithm that allows one to understand ulnar sided wrist pain. Contemporary diagnostic maneuvers and imaging techniques will be presented in the context of our current understanding of the anatomy, biomechanics and pathomechanics that affect patients' presentations. Current treatment options, both open and arthroscopic, will be discussed and demonstrated via video to highlight surgical pearls and techniques.

Objectives: Following this session, the participant will be able to:

1. Understand how the biomechanics of the DRUJ contributes to clinical presentation.
2. Recognize solutions to achieving optimal outcomes

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.

Objectives: Following this session, the participant will be able to:

1. Discuss the diagnosis and treatment of skin lesions commonly encountered on the upper extremities
2. Provide pearls and pitfalls for the management of benign and malignant skin lesions commonly seen on the upper extremity
3. Aid the hand surgeon in knowing how to manage complications associated with common skin lesions encountered on the upper extremities

Participants in this course will learn which flaps can reliably provide coverage for wounds of the hand. This will cover large wounds and smaller wounds of the fingers and thumb. Esoteric and unreliable flaps will be eschewed for those that can help the average hand surgeon provide coverage of most hand wounds.

Objectives: Following this session, the participant will be able to:

1. Narrow their choices for flap coverage in the hand to those which are the best.
2. Better understand flap anatomy in hand coverage.
3. Improve their knowledge of indications for certain flaps in the hand.
4. Provide more appropriate coverage for hand wounds.

This course will address how to recognize and treat complex radial articular fractures. It will also evaluate soft tissue and ensuing bone complications that every wrist and trauma surgeon will encounter.

Objectives: Following this session, the participant will be able to:

1. Identify correct indications for volar plating and alternative techniques.
2. Understand principles of fracture stability and means to predict fracture collapse in plaster.
3. Describe treatment options and salvage for failed internal fixation of the distal radius.
4. Detail nerve and tendon complications of internal fixation and strategies for treatment.
5. Describe indications and techniques for treatment of nonunion/malunion of distal radius fractures.
6. Understand management options for acute and chronic radioulnar instability.

This course will address evaluation and treatment options for the patient who has failure of thumb CMC arthroplasty. The process of diagnosis, evaluation, and rehabilitation, including evaluation of the metacarpophalangeal (MCP) joint hyperextension for its contribution to failure, soft tissue revision surgery, the use of arthroplasty fusion, and therapy modalities will be discussed.

Objectives: Following this session, the participant will be able to:

1. Identify the etiology and diagnostic workup of the failed thumb CMC arthroplasty.
2. Discuss the contribution of thumb MCP joint hyperextension to failure of CMC arthroplasty.
3. Discuss surgical and therapeutic options for treatment of the failed thumb CMC arthroplasty.

While carpal tunnel release remains the most commonly encountered compression neuropathy in hand surgery, increasing clinical evidence is highlighting the importance of diagnosing and treating proximal forearm compressions. Are we as hand surgeons able to recognize the light at the end of the tunnel? In this course, the panel will discuss anatomy and clinical presentations of forearm compressions; debate the use of radiological or neurophysiological analysis and discuss treatment options for radial, median and ulnar nerve compressions in the proximal forearm/elbow.

Objectives: Following this session, the participant will be able to:

1. Identify anatomic structures and variations that contribute to forearm nerve compression.
2. Describe diagnostic algorithms for accurate diagnosis.
3. Choose conservative and surgical options based on above and best clinical evidence.
4. Describe treatment options and expected outcomes.

This course will review the mechanics of acute and chronic mallet injuries and boutonniere deformities. Nonoperative treatment, including splinting techniques, will be reviewed. Surgical treatment of both the acute injuries and the secondary deformities will also be discussed. An evidence based review of the literature will be used to help guide medical decision making between these techniques. Case presentations will also be utilized to highlight teaching points.

Objectives: Following this session, the participant will be able to:

1. Differentiate how injury and disease processes alter biomechanics to create Mallets and Boutonnieres deformities.
2. Choose the simplest and most effective conservative and surgical solutions calibrating clinical rationale and evidence.
3. Describe key technical details and expected outcomes.

Therapists often advise the public with respect to health care issues. Individuals with upper extremity problems may ask a hand therapist, "Do you think I need to see a doctor for this? Really, then what kind of doctor?" Often the inquirer will deny any need for intervention, "Its only jammed; I can still move it".
This is when a hand therapist is the hand surgeon's best friend.

Hand surgery, behind a curtain or wide awake, is relatively passive and painless. During therapy sessions, the hand therapist has ample time to observe posture, use/disuse, pain behaviors, and coping strategies. Alerting the hand surgeon to potential red flags in the patient's recovery is important.
This is when a hand therapist is the hand surgeon’s best friend.

Hand therapists are aware of the complications inherent with each fracture. The slight extensor lag of today, could be the joint contracture of tomorrow. The FDP restricted glide today means reduced grip strength tomorrow.
This is when a hand therapist is the hand surgeon’s best friend.

Objectves:

1. Understand that regaining function post hand fracture is built on restoring skeletal anatomy and recovery of tissue mobility.
2. Recognize that the number one complication of hand fractures is not mal-union or nonunion, rather it is joint stiffness.
3. Hand Therapists need to be aware of the potential complications related to each fracture type with the appropriate intervention

Hand therapists play an important role in maximizing patient outcomes for both post-operative and non-operative conditions. The panelists will discuss the effectiveness of select therapy interventions highlighting current evidence and clinical wisdom.

Objectives: Following this session, the participant will be able to:

1. Discuss current concepts in therapy assessment and interventions for hand and upper extremity conditions in which pain is a predominant symptom.
2. Identify appropriate therapy interventions to optimize: motion; joint stability; muscle performance; and function.
3. Integrate current evidence and clinical pearls into clinical decision making regarding appropriate referral to hand therapy.

This panel will provide the latest on these minimally invasive treatments for Dupuytrens. The concept that stretching cords does not work or will aggravate the cord is passé; the digit widget has proven this. Fat grafts do survive in the hand; surgical method and the evidence supporting the technique will be presented. Needle aponeurotomy is here to stay and continues to get better. Collagenase is an adjunctive tool which can be used in many new ways alone or with other treatments.

Objectives: Following this session, the participant will be able to:

1. Use collagenase in new ways for maximal effect to get better results.
2. Incorporate fat grafting as part of needle aponeurotomy to decrease recurrence times.
3. Use stretching of the cords with digit widget, splinting or exercises before or after surgery to improve results and help them last longer.
4. Use new practical pointers to improve their needle aponeurotomy technique.

Panelists will present their best simple solutions on how to improve results for common flexor and extensor injuries. The panel will debate the merits of the 3 following areas of tendon management: 1) Wide awake flexor tendon repair vs. repair with non-active patient participation repair with Bier/plexus blocks or GA. 2) Early protected movement of zones 3-7 extensor tendon injuries with relative motion vs. static splinting. 3) "True active" vs. "place and hold" early protected movement after flexor tendon repair.

Objectives: Following this session, the participant will be able to:

1. Acquire insight into simple solutions that may improve their flexor and extensor tendon results.
2. Use new concepts in early protected movement after extensor and flexor tendon repair to get better outcomes.
3. Understand the pros and cons of tendon repair using the wide awake and non-active patient traditional approach to flexor tendon repair.

Dr. Tang will walk you through each critical step of primary flexor tendon repair in the digital sheath area, with explanation of the method details that he currently uses in the practice, and his own methods and protocols of active finger flexion postsurgery. The critical surgical techniques will be carefully explained with support of basic science investigations. This talk reflects the current trend in primary flexor tendon repair and covers major paradigm shifts over the past 2 decades in the management of the tendon sheath, major pulleys, techniques of suturing the tendon, early active motion of the repaired tendon, and revealing work led by internationally lead experts including Dr. Tang.

Objectives: Following this session, the participant will be able to:

1. Understand the current views of flexor tendon repairs and pulley treatment.
2. Learn surgical repair methods of the lacerated digital flexor tendons.
3. Analyze the current trends of rehabilitation after flexor tendon repair.
4. Develop key points of early active tendon motion after repair.
5. Recognize the critical clinical aspects for best surgical outcomes.

The AAHS Principles of Internal Fixation in the Wrist and Hand Workshop is a Surgeons Workshop designed to provide participants an opportunity to learn techniques for internal fixation and technical pearls in wrist and hand fractures as well as fusion options from an expert faculty panel and put them into practice in a hands-on sawbone workshop.

Objectives: Following this session, the participant will be able to:

1. Recognize fracture patterns and characteristics in the distal radius and perform volar plating and fragment specific plating in a distal radius sawbone model.
2. Demonstrate on a saw bone model the application of basic principles of lag screw fixation, neutralization plate, and compression plating in hand fractures.
3. Discuss surgical options for fusion in the wrist and hand and perform them in a sawbone model.

The AAHS Moving Evidence on Active Motion into Practice is a Therapists Workshop designed to provide participants an opportunity to learn techniques when implementing tests, practices and interventions that have supporting evidence adding clinical pearls that arisen from in the experience of expert faculty when implementing active strategies into practice.

Objectives: Following this session, the participant will be able to:

1. Execute an early active motion program for flexor tendon repairs.
2. Fabricate a dart throwers motion splint.
3. Screen for balance problems and execute a simple home exercise program for balance suitable for patients recovering from distal radius fracture.
4. Understand and fabricate relative motion flexion and extension splints.
5. Early active motion for hand fractures.

This MOC-approved course will present updates on the comprehensive care of patients with Dupuytrens disease. This is a rapidly changing field because of new treatment modalities such as collagenase and needle aponeurotomy. The course will span from minimally invasive techniques to open surgery, with hand therapy guidelines for each treatment. Best available evidence will be presented. Cases will be presented to allow for discussion of various treatments. Lastly, updates on the MOC processes for plastic and orthopedic surgeons will be presented.

Objectives: Following this session, the participant will be able to:

1. Learn optimal surgical techniques for care of patients with Dupuytrens disease.
2. Learn alternative methods of treatment including collagenase and needle aponeurotomy
3. Learn post-treatment hand therapy modalities for Dupuytrens disease
4. Review cases to discuss various treatment options
5. Understand the Maintenance of Certification schedule for Plastic Surgery and Orthopedic Surgery

Scapholunate instability is the most common form of carpal instability yet its diagnosis can be difficult, and its successful treatment can be even more complicated. This course will apply the best evidence to help the surgeon make the diagnosis of SL injury through physical exam, MRI and arthroscopy. A review of our current understanding of the anatomy, biomechanics and pathomechanics will be provided followed by the presentation of a treatment algorithm incorporating both open and arthroscopic techniques.

Objectives: Following this session, the participant will be able to:

1. Describe the typical injury and biomechanical consequences that define scapholunate injuries.
2. Choose the simplest and most effective conservative and surgical solutions calibrating clinical rationale and evidence.
3. Describe key technical details and expected outcomes

The management of symptomatic PIPJ arthritis remains a significant challenge and the optimum treatment modality for any particular patient scenario is difficult to define from available published data. The specific goals in treatment, in order of importance, are pain relief, stability for pinch and grip, and range of motion. This course will review the ideal indications for each of the available treatment options and present the practical experience of the course instructors. There will be a particular focus on technical aspects for optimizing surgical outcomes for each treatment option as well as a detailed review of the post-operative rehabilitation.

Objectives: Following this session, the participant will be able to:

1. Choose the simplest and most effective reconstructive options calibrating clinical rationale and evidence.
2. Define potential surgical complications and their risk management.
3. Describe key technical details and expected outcomes.
4. Discuss key principles and evidence for post-operative rehabilitation

Athletic injuries to the hand and wrist are common and can be quite disabling which may delay the athlete or weekend warrior from returning to competition for some time. This course discusses the surgical management and rehabilitation of athletic hand injuries in an attempt to return the athlete to sport as soon and safely as possible.

Objectives: Following this session, the participant will be able to:

1. Describe the typical injuries across different sports.
2. Choose the simplest and most effective conservative and surgical solutions for the elite athlete.
3. Discuss clinical decision making about time to safe return to sport

This course will review the state of the art with regard to tendon repair and rehabilitation in the hand, emphasizing techniques that are available now for clinical use. Both flexor and extensor tendons will be discussed.

Objectives: Following this session, the participant will be able to:

1. Describe suture methods associated with improved outcomes after tendon repair in the hand
2. Describe rehabilitation methods associated with improved outcomes after tendon repair in the hand
3. Describe the scientific evidence supporting methods of tendon repair and rehabilitation in the hand

To err is human. Surgery is done with a knife. Adverse events are inevitable and they are taxing and disheartening. At a time when the surgeon is at his or her most vulnerable, we need to support our patient and their family through an unexpected challenge. It's surprising how similar it feels when there is no mistake or shortcoming but the patient perceives one. For instance, a patient with severe carpal tunnel syndrome that is disappointed that the numbness persists after surgery or a patient with residual pain after successful trapeziometacarpal arthroplasty. In an interactive, open, case-based forum format, 3 hand surgeons will lead a discussion of methods for addressing the adverse events and the unsatisfied customer.

Objectives: Following this session, the participant will be able to:

1. Have a strategy for handling adverse events.
2. Understand how to set up your practice for optimal customer service.
3. Know the key aspects of developing a trusting and collaborative patient-doctor relationship.

The purpose of this Instructional Course is to describe the presentation and examination of patients with obstetric brachial plexus injury with special focus on the shoulder. The essential role of early physical therapy as well as its importance for late presentations are emphasized. The role of early nerve reconstruction versus later shoulder soft tissue reconstructions are discussed. We will also share our most up to date knowledge on the natural history of the obstetric brachial plexus injury.

Objectives: Following this session, the participant will be able to:

1. Discuss the diagnostic and timing issues that direct surgical planning.
2. Choose the simplest and most effective surgical solutions calibrating clinical rationale and evidence.
3. Describe key technical details and expected outcomes.
4. Describe the rehabilitation principles for treatment and outcome evaluation

In this Instructional Course, the panel will discuss when and when not to operate on simple hand fractures; when to use K-wires and when to use plates; management of soft tissue loss, and rehabilitation of metacarpal and phalangeal fractures. The final half hour will be case controversies related to hand fractures.

Objectives: Following this session, the participant will be able to:

1. Identify common and problematic finger fractures.
2. Choose the simplest and most effective conservative and surgical solutions calibrating clinical rationale and evidence.
3. Describe key technical details and expected outcomes

8:15 am - 10:00 am	CONCURRENT SCIENTIFIC SESSION I: Arthritis/Trauma (Main Science Room)
8:15 am - 8:20 am	Overview: Arthritis Mark Rekant, MD
8:20 am - 8:22 am	1. Ideal Fusion Angle For Thumb Interphalangeal Joint Arthrodesis Danielle Cross, MD; Kristofer S. Matullo, MD Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, PA
8:22 am - 8:24 am	2. A New Adjustable Dynamic External Fixator for Fracture-Dislocations of the Proximal Interphalangeal Joint: a Cadaver Study Kun Liu, MD1, Jean-Yves Beaulieu, MD2, Pierre Hoffmeyer, MD2, Guanglei Tian, MD1; Jan van Aaken, MD2 1Hand Surgery Department, Beijing Jishuitan Hospital, Beijing, China; 2Orthopaedic Department, Geneva University Hospital, Geneva, Switzerland
8:24 am - 8:26 am	3. Biomechanics of the Thumb Metacarpophalangeal Joint in Athletes: Development of a Computational Model for Injury Prevention A. Samandar Dowlatshahi, MD1; David A. Polito2; Tyler Wood2; Joseph B. Rucco2; Douglas M. Rothkopf, MD1 1Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, MA; 2Worcester Polytechnic Institute, Worcester, MA
8:26 am - 8:28 am	4. A Novel Intramedullary PIP Arthrodesis Construct Outperforms Standard Techniques Scott Hadley, MD1, Paolo Caravaggi, PhD2, Steven Rivero, BS2, Benhoor Shamian, MD2; John Capo, MD1 1NYU-Hospital for Joint Diseases, New York, NY; 2Department of Orthopaedics, University of Medicine and Dentistry of New Jersey- New Jersey Medical School, Newark, NJ
8:28 am - 8:30 am	5. Activation of the First Dorsal Interosseous Muscle Results in Radiographic Reduction of the Thumb CMC Joint: Implications for Arthritis Intervention Corey McGee, OTR/L, CHT; Julie E. Adams, MD; Sara S. Van Nortwick, MD; Virginia H. O'Brien, OTD, OTR/L, CHT; Ann E. Van Heest, MD University of Minnesota, Minneapolis, MN
8:30 am - 8:40 am	Panel Discussion Mark Rekant, MD; Douglas M. Sammer, MD; Kristin A. Valdes, OTD, OTR, CH
8:40 am - 8:42 am	6. Botulinum Toxin Type-A Blocks Sodium Channels: A Possible Mechanism in the Treatment of Chronic Hand Pain Kelli N. Webb, MD1; Louis S. Premkumar, PhD2; Michael W. Neumeister1 1Division of Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield, IL; 2Department of Pharmacology, Southern Illinois University, Springfield, IL
8:42 am - 8:44 am	7. Save the Trapezium in Thumb CMC Osteoarthritis Jorge Luis Orbay, MD The Hand Institute, Miami, FL
8:44 am - 8:46 am	8. Arthroscopic Trapeziectomy with Suture Button Suspensioplasty for Symptomatic Carpo-metacarpal Arthritis Genevieve Landes, MD; Abdo Bachoura, MD; Sidney M. Jacoby, MD; A. Lee Osterman, MD; Randall W. Culp, MD Hand Surgery, The Philadelphia Hand Centers, Thomas Jefferson University, Philadelphia, PA
8:46 am - 8:48 am	9. The Radiologic Prevalence of Trapeziometacarpal Arthrosis David C. Ring, MD; Stéphanie Becker; Jan Paul Briet; Michiel Hageman Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston
8:48 am - 8:53 am	10. Treatment of Metacarpophalangeal Joint Traumatic Defects Using a Pedicle Osteoarticular Flap from the 3rd Carpometacarpal Joint in 27 Cases With Follow-up Over 2 Years Xu Zhang, MD Hand Surgery Department, The Second Hospital of Qinhuangdao, Changli, Qinhuangdao
8:53 am - 9:05 am	Panel Discussion Mark Rekant, MD; Douglas M. Sammer, MD; Kristin A. Valdes, OTD, OTR, CH
9:05 am - 9:10 am	Overview: Trauma Asif Ilyas, MD
9:10 am - 9:12 am	11. Prospective Randomized Repair of the Pronator Quadratus Following Volar Plate Fixation of Distal Radius Fractures Rick Tosti1; Asif M. Ilyas, MD2 1Orthopaedic Surgery and Sports Medicine, Temple University, Philadelphia, PA; 2Rothman Institute, Thomas Jefferson University, Philadelphia, PA
9:12 am - 9:14 am	12. A Novel, Less Invasive Approach to Distal Radius Fracture Fixation – Prospective Case Series with One Year Follow-up Michael K. Strassmair, MD1; Daniel A. Rikli2; Jorg Schmidt, Dr, med3; Hans-Josef Erli, Dr, med4 1Klinikum Starnberg, Starnberg, Germany; 2University Hospital Basel, Basel, Switzerland; 3Klinik fur Orthopadie, Unfall-, Hand und Wiederherstellungshirurgie - Unfallklinik, Asklepios Klinik Weissenfels-Hohenmolsen GmBH, Weissenfels, Germany; 4Klinik fur Unfallchirurgie und Orthopadie, Vinvantes Humboldt-Klinikum, Berlin, Germany
9:14 am - 9:16 am	13. The Role Of Prophylactic Antibiotics In Hand Trauma: A Systematic Review and Meta-Analysis Jennifer Alicia Klok, MSc, MD; Rosalind Ashton, MD; Kirsty Usher Boyd, MD, FRCSC Department of Surgery, Division of Plastic Surgery, University of Ottawa, Ottawa, ON, Canada
9:16 am - 9:18 am	14. Early Complications after Open Treatment of Distal Radius Fractures Cameron W. Schick, MD; Christopher Martin, MD; Yubo Gao, PhD; Andrew Pugely, MD; Apurva Shah, MD, MBA; Brian Adams, MD Orthopaedic Surgery, University of Iowa, Iowa City, IA
9:18 am - 9:20 am	15. Metacarpal Fracture Fixation Using Intramedullary Pins (IM Pins) Compared to Kirschner Wires (K-Wires) Zachary A. Reese; Abdo Bachoura; Sidney M. Jacoby; Randall W. Culp Philadelphia Hand Center, Philadelphia, PA
9:20 am - 9:35 am	Panel Discussion Asif Ilyas, MD; Warren C. Hammert, MD; Miguel A. Pirela-Cruz, MD, Mike Szekeres, OTR, CHT
9:35 am - 9:37 am	16. Unstable Metacarpal Fractures Treated with Intramedullary Nail Fixation Ather Mirza, MD; Justin B. Mirza, DO Ather Mirza, Smithtown, NY
9:37 am – 9:39 am	17. Factors Associated with Transfer of Hand Injuries to a Level I Trauma Center: An Analysis of 1,147 Cases Parag Butala, MD; Mark D. Fisher, MD; Gert Bluschke, MD; David S. Ruch, MD; Marc J. Richard, MD; Scott T. Hollenbeck, MD; Howard Levinson, MD; Fraser J. Leversedge, MD; Detlev Erdmann, MD, PhD, MHSc Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Durham, NC
9:39 am – 9:41 am	18. Skin Surface Pressures under Short Arm Casts Christian J. Zaino, MD; Melissa S. Arief, MD, MHS; Mukund R. Patel, MD Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, NY
9:41am - 9:43 am	19. Predictors of Adult Upper Extremity Compartment Syndrome: Which Factors Are Most Predictive - Vital Signs, Narcotic Administration, or Physical Examination Ehsan Jazini, MD1; Christine Helou, BS1; Ebrahim Paryavi, MD, MPH1; M. Sadegh Asadi, MD2; Joshua M. Abzug, MD1 1Orthopaedics, University of Maryland School of Medicine, Baltimore, MD; 2Neurology, Howard University, Washington, DC
9:43 am - 9:48 am	20. Experience of Arthroscopic Bone Grafting for Scaphoid Nonunion and Delayed Union in 100 Cases PC Ho, MD Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
9:48 am - 10:00 am	Panel Discussion Asif Ilyas, MD; Warren C. Hammert, MD; Miguel A. Pirela-Cruz, MD, Mike Szekeres, OTR, CHT
8:15 am - 10:00 am	CONCURRENT SCIENTIFIC SESSION II: Tendon/Congenital (Concurrent Science Room)
8:15 am - 8:20 am	Overview: Tendon Karim Bakri, MD
8:20 am - 8:22 am	21. Minimally Invasive High Resolution Ultrasound Guided Trigger Finger Release Brian Jurbala, MD Highland Center for Orthopaedics, Lakeland, FL
8:22 am - 8:24 am	22. The Incidence of Trigger Digit after Carpal Tunnel Release Louis C. Grandizio, DO; John D. Beck, MD; Michael R. Rutter, BS; Jove Graham, PhD; Joel C. Klena, MD Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
8:24 am - 8:26 am	23. Surgical Setting and Cost Effectiveness in Trigger Finger Release Elliot P. Robinson, MD; Glenn Gaston, MD Hand Surgery Fellowship, University of Virginia, Charlottesville, VA; 2OrthoCarolina, Carolinas Medical Center, Charlotte, NC
8:26 am - 8:28 am	24. Office Based Trigger Finger Release Andrew K. Palmer, MD1; Dale Dellacqua, MD2 1Orthopedic Surgery, Upstate Medical University, Syracuse, NY; 2Department of Orthopedics, Indiana University; Monroe Hospital, Bloomington, IN
8:28 am - 8:30 am	25. Changes in Blood Glucose Levels after Corticosteroid Injection in the Hand and Wrist Jeffrey Stepan, BS; Daniel A. London, BA; Ryan P. Calfee, MD, MSc; Martin I. Boyer, MD Department of Orthopedic Surgery, Washington University, St. Louis School of Medicine, St. Louis, MO
8:30 am - 8:40 am	Panel Discussion Karim Bakri, MD; Jason H. Ko, MD; Sharon Andruskiwec, PT, CHT
8:40 am - 8:45 am	Overview: Tendon Jason H. Ko, MD
8:45 am - 8:47 am	26. Histopathologic Changes in DeQuervain's Tendinosis: A Correlation Between Clinical and Pathologic Severity Rowena McBeath, MD, PhD; A. Lee Osterman, MD The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA
8:47 am - 8:49 am	27. Biomechanical Properties of Donor Tendons in the Forearm and Hand Timothy F. Tirrell1; Siddharth Bhola, MD1; John J. Finneran, MD2; Reid A. Abrams, MD1; Jan Fridén, MD, PhD3; Richard L. Lieber, PhD1 1Department of Orthopaedics, University of California, San Diego, San Diego, CA; 2Department of Anesthesia, University of California, San Diego, San Diego, CA; 3Department of Hand Surgery, Sahlgrenska University Hospital, Goteborg, Sweden
8:49 am - 8:51 am	28. WITHDRAWNClinical Outcomes of Forearm Fasciectomy for Treatment of Chronic Exertional Forearm Compartment Syndrome at Minimum One Year Follow-up Benjamin R. Wiseley, BS; William D. Turnipseed, MD; Jonathan L. Tueting, MD University of Wisconsin School of Medicine and Public Health, Madison, WI
8:51 am - 8:56 am	29. Clinical Use of Tendon Allograft in Tendon Reconstruction in the Hand: Follow-Up Results and Problems Youle Zhang, MD; Lui Kun, MD Department of Hand Surgery, Jishuitan Hospital, Beijing, China
8:56 am - 9:01 am	30. A Sensitive Method to Quantify Gap Formation of Tendon and its Use in Mechanical Investigation of Tendon Repair Ya Fang Wu, MD Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong, China
9:01 am - 9:10 am	Panel Discussion Karim Bakri, MD; Jason H. Ko, MD; Sharon Andruskiwec, PT, CHT
9:10 am - 9:15 am	Overview: Peds Amir H. Taghinia, MD
9:15 am - 9:17 am	31. The Outcome of Total Distal Radioulnar Joint Arthroplasty in Madelung Deformity Roongsak Limthongthang, MD1; Ryan M. Zimmerman, MD2; Luis Scheker3; Douglas P. Hanel, MD4; Richard A. Berger, MD, PhD5; Jesse B. Jupiter, MD6 1Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard University, Boston, MA; 3Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY; 4Hand and Wrist Services, Harborview Medical Center, University of Washington, Seattle, WA; 5Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN; 6Hand and Upper Extremity Services, Massachusetts General Hospital, Boston, MA
9:17 am - 9:19 am	32. Revision of Neuroma after Primary Suture Ligation of Rudimentary Post Axial Polydactyly: A Case Series Mark Tait, MD; Tyler Carllee; Kimberly McCain, RN; Theresa Wyrick, MD Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
9:19 am - 9:21 am	33. A Stepwise Surgical Approach Resolves Camptodactyly Kristy L. Hamilton, BA; David T. Netscher, MD Department of Orthopedic Surgery and Division of Plastic Surgery, Baylor College of Medicine, Houston, TX
9:21 am - 9:26 am	34. Flexion Crease And Web Space Reconstruction for Aesthetic and Functional Correction of Congenital Syndactyly: Results in 116 Consecutive Patients Bin Wang, MD; Ni Feng, MD; Cao Yi, MD Department of Plastic and Reconstructive Surgery, The 9th People’s Hospital, Shanghai, China
9:26 am - 9:31 am	35. Reconstruction of Hypoplastic Thumb with Unstable Carpometacarpal Joint Using Hemi-Metatarsal Transfer: Report of Minimal 9 Years Outcomes in 8 Patients Wing Lim Tse, MD Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
9:31 am - 9:40 am	Panel Discussion Amir H. Taghinia, MD; Brian I. Labow, MD; Linda C. Cendales, MD; Thomas H. Tung, MD
9:40 am - 9:45 am	Overview: VCA Hand Transplant Linda C. Cendales, MD
9:45 am - 9:47 am	36. Adjustment to Amputation and Attitudes Toward Upper Limb Transplantation: Implications for Patient Selection Sally E. Jensen, PhD; Zeeshan Butt; Allen W. Heinemann; David Cella; Todd A. Kuiken, MD, PhD; Gregory A. Dumanian Northwestern University Feinberg School of Medicine, Chicago, IL
9:47 am - 9:49 am	37. Measuring the Utility of Hand Composite Tissue Allotransplantation in Hand Amputee Patients Noor Alolabi, MD1; Jennifer Chuback, MD1; Sharon Grad, MD, FRCP(C)2; Achilles Thoma, MD, MSc, FRCS(C)3 1Division of Plastic Surgery, McMaster University, Hamilton, ON, Canada; 2Division of Physical Medicine and Rehabilitation, McMaster University, Hamilton, ON, Canada; 3Department of Surgery, Division of Plastic Surgery, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada
9:49 am - 9:51 am	38. Perceptions of Upper Limb Transplantation Benefits and Risks: The Amputee Perspective Sally E. Jensen, PhD; Zeeshan Butt Department of Medical Social Sciences, Department of Surgery (Organ Transplantation), Northwestern University Feinberg School of Medicine , Chicago, IL
9:51 am - 10:00 am	Panel Discussion Amir H. Taghinia, MD; Brian I. Labow, MD; Linda C. Cendales, MD; Thomas H. Tung, MD

10:30 am - 11:45 am	CONCURRENT SCIENTIFIC SESSION III: Microvascular/ Flaps (Main Science Room)
10:30 am - 10:35 am	Overview: Microvascular Jason H. Ko, MD
10:35 am - 10:37 am	39. Inadvertent Intra-Arterial Drug Injections in the Upper Extremity: A Review of Literature Kevin D. Han, MD1; Chaitan Devulapalli, MD2; Ryan D. Katz, MD1 1Curtis National Hand Center, Union Memorial Hospital, Baltimore, MD; 2Department of Surgery, Georgetown University Hospital, Washington, DC
10:37 am - 10:39 am	40. Impact of the Number of Vein Repair in Short-Term Digital Replantation Survival Rate Johnny I. Efanov; Demitrios Rizis; Genevieve Landes; Joseph Bou-Merhi; Patrick G. Harris; Alain M. Danino Plastic Surgery, Montreal University Hospital, Montreal, QC, Canada
10:39 am - 10:41 am	41. Functional and Aesthetic Outcomes of the Fingertips after Nail Lengthening Using the Eponychial Flap Hsin-Yu Chen, MD; Chung-Chen Hsu, MD; Yu-Te Lin, MD; Chih-Hung Lin, MD; Cheng-Hung Lin, MD Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
10:41 am - 10:43 am	42. Posterior Elbow Soft-tissue Reconstruction Using a Flexor Carpi Ulnaris Muscle Turnover Flap William Slikker, MD1; Christopher Bayne, MD1; Jianjun Ma, MD2; Fraser Leversedge, MD2; Mark Cohen, MD1; Robert Wysocki, MD1 1Rush University, Chicago, IL; 2Orthopedics, Duke University, Durham, NC
10:43 am - 10:45 am	43. Functional Reconstruction of the Digit with Palmaris Longus Tendocutaneous Arterialized Venous Free Flaps Sang-Hyun Woo, MD, PhD1; Young-Keun Lee, MD, PhD2; Ho-Jun Cheon, MD1; Young-Woo Kim1 1Cheon & Woo's Institute for Hand & Reconstructive Microsurgery, W Hospital, Daegu, South Korea; 2Dason Orthopedic Clinic, Jeonju, South Korea
10:45 am - 10:47 am	44. Improved Compliance via Regional Immunosuppression Induces Long-term Survival in Vascularized Composite Allotransplantation Jignesh Unadkat, MD, MRCS1; Jonas Schnider, MD1; Kacey Marra, PhD1; Mario Solari, MD1; Angus Thomson, PhD2; Alexander Spiess, MD1 1Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, 2Immunology, Transplantation, University of Pittsburgh, Pittsburgh, PA
10:47 am - 11:05 am	Panel Discussion Jason H. Ko, MD; William C. Pederson, MD; Karim Bakri, MD; Mark Henry, MD
11:05 am - 11:10 am	Overview: Microvascular Karim Bakri, MD
11:10 am - 11:12 am	45. Disappearing Digits: Analysis of National Trends in Amputation and Replantation Patrick L. Reavey, MD, MS; Marc Soares, MD; Vishal Thanik, MD Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY
11:12 am - 11:14 am	46. The Clinical Course of Hand Transplantation: Experience of Unanticipated Events Edward Davidson, MA, (Cantab), MBBS; Alexander Spiess, MD; Mario Solari, MD; Kia Washington, MD; Joseph Losee, MD; Vijay Gorantla, MD Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA
11:14 am - 11:16 am	47. Ultrashort-Pedicle Toe Tip Transfer Assisted by Non-Enhanced Angiography Hidehiko Yoshimatsu, MD; Takumi Yamamoto; Mitsunaga Narushima; Takuya Iida; Isao Koshima Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan
11:16 am - 11:18 am	48. Finger Tip Replantation-Ultramicrosurgery Technique and its Postoperative Therapy Hiroyuki Gotani, MD, PhD Hand Surgery, Osaka Trauma and Microsurgery Center, Osaka, Japan
11:18 am - 11:23 am	49. Modified Wrap-Around Flap for Thumb Reconstruction in 73 Cases: Techniques and Follow-Up Results Yongwei Pan, MD Departmet of Orthopaedic Surgery, Tsinghua Hospital, Tsinghua University, Beijing, China
11:23 am - 11:28 am	50. Comprehensive Thumb/Finger Reconstruction by Composite Tissue Transfers from Different Parts of the Body: Report of 719 Thumbs/Fingers in 636 Patients Zeng Tao Wang, MD Department of Hand and Foot Surgery, Shandong Provincial Hospital, Jinan, Shandong, China
11:28 am - 11:45 am	Panel Discussion Jason H. Ko, MD; William C. Peterson, MD; Karim Bakri, MD; Mark Henry, MD
10:30 am - 11:45 am	CONCURRENT SCIENTIFIC SESSION IV: Dupuytrens / Tumor (Concurrent Science Room)
10:30 am - 10:35 am	Overview: Dupuytrens Marco Rizzo, MD
10:35 am - 10:37 am	51. Nonsurgical Treatment of Dupuytren's Contracture: Three-Year Safety Results Using Collagenase Clostridium Histolyticum Clayton A. Peimer, MD1; Claudia McGoldrick2; Gregory J. Kaufman, MD2 1College of Human Medicine, Michigan State University, Marquette, MI; 2Auxilium Pharmaceuticals, Inc, Chesterbrook, PA
10:37 am - 10:39 am	52. Use of Local Anesthesia Prior to Finger Extension Following Injection of Collagenase Clostridium Histolyticum for Dupuytren's Contracture Stephen Coleman, MBBS1; David Gilpin, MBBS1; Nigel Jones, BSc2; James P. Tursi, MD3; Brian M. Cohen, PhD3; Gregory J. Kaufman, MD3 1Brisbane Hand & Upper Limb Center, Brisbane, Australia, 2Auxilium Pharmaceuticals, Inc, Windsor, United Kingdom, 3Auxilium Pharmaceuticals, Inc, Chesterbrook, PA
10:39 am - 10:41 am	53. Randomized Prospective Clinical Trial Comparing Manipulation of Dupuytren's Contracture at 7 days versus 1 day Following Collagenase Injection Shelley S. Noland, MD1; Andrew J. Watt, MD2; Dayne Mickelson, MD1; Kathleen M. Kollitz, BS1; Nicholas B. Vedder, MD1; Jerry I. Huang, MD1 1Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA; 2The Buncke Clinic, California Pacific Medical Center, San Francisco, CA
10:41 am - 10:43 am	54. Treatment of Recurrent Dupuytren's Contractures in Joints Effectively Treated With Collagenase Clostridium Histolyticum: Interim Results Clayton A. Peimer, MD1; Chris Bainbridge, MBChB, FRCS2; Stephan Wilbrand, MD3; Gregory J. Kaufman, MD4; James P. Tursi, MD4; Ted Smith, PhD4; Yan Ling, MD, PhD4 1College of Human Medicine, Michigan State University, Marquette, MI; 2Department of Hand Surgery, The Pulvertaft Hand Unit, Derby, United Kingdom; 3Uppsala University Hospital, Uppsala, Sweden; 4Auxilium Pharmaceuticals, Inc, Chesterbrook, PA
10:43 am - 10:45 am	55. Outcomes Following Surgical Fasciectomy and Collagenase Enzymatic Fasciotomy for Dupuytren's Contracture Stacey Lynne Gold, BS1; Michael J. Waters, BMBS, BPhysio2; Raghuveer C. Muppavarapu, MD3; David E. Ruchelsman, MD2; Matthew I. Leibman, MD2; Mark R. Belsky, MD2 1School of Medicine, Tufts University, Boston, MA; 2Hand Surgery PC, Newton Wellesley Hospital, Newton, MA; 3Orthopedic Surgery, Tufts Medical Center, Boston, MA
10:45 am - 10:47 am	56. The Quality of Orthopaedic Care in 108 Upper Extremity Malpractice Claims Filed and Claims Paid Jerry I. Huang, MD; Linda S. Stephens, PhD; Jocelyn L. Jette, BS; Winston J. Warme, MD; Karen L. Posner, PhD; Frederick A. Matsen, MD1 University of Washington, Seattle, WA
10:47 am - 11:05 am	Panel Discussion Marco Rizzo, MD; Jeffrey B. Freidrich, MD; Sandra K. Reese, OTR/L, CHT
11:05 am - 11:10 am	Overview: Tumor Sanjeev Kakar, MD
11:10 am - 11:12 am	57. A Systematic Review of Outcomes of Treating Enchondroma of the Hand Abdo Bachoura, MD; John D. Lubahn, MD Orthopaedic Surgery, UPMC Hamot, Erie, PA
11:12 am - 11:14 am	58. Lesions of the Fingers - A 15 year Surgical Pathology Review Jenna-Lynn B. Senger; Dale Classen, MD, FRCS; Rani Kanthan, MBBS, MS, FRCS University of Saskatchewan, Saskatoon, SK, Canada
11:14 am - 11:16 am	59. Non-Melanoma Skin and Soft-Tissue Tumors of the Upper Limb: Epidemiological Casuistry, Surgical Treatment and Mid-Long Term Outcome Ivan Couto-González, MD; Beatriz Brea-García, MD; Antonio Taboada-Suárez, MD, PhD Plastic and Reconstructive Surgery, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
11:16 am - 11:18 am	60. Predicting the Risk of Pathologic Fracture for Enchondromas of the Hand Using Reproducible Clinical and Radiographic Criteria Scott Riester, MD; Rishi Ramaesh, MD; Doris Wenger, MD; Andre van Wijnen, PhD; Sanjeev Kakar, MD Orthopedic Surgery, Mayo Clinic, Rochester, MN
11:18 am - 11:20 am	61. Addition of the LGR6+ Epithelial Stem Cell from Skin Results in Enhanced Levels Bone Production and a Progressive Osteogenic Lineage Denver Matthew Lough, MD, PhD1; Damon S. Cooney, MD, PhD2; Shaun Mendenhall, MD1; Joel Reichensperger, BS1; Lisa Cox, BS1; Nicole Cosenza, MS1; Carrie Harrison, BS1; Michael W. Neumeister, MD1 1Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL; 2Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
11:20 am - 11:45 am	Panel Discussion Sanjeev Kakar, MD; Stephanie N. Toomey, OTR/L, CHT

The quote "less is more" is attributed to Ludwig Mies van der Rohe - German born American Architect 1886-1969. It is a philosophy which can be very helpful in life and in hand surgery. "Simple solutions welcome!" is a form of "Less can be more".

Objectives: Following this session, the participant will be able to:

1. Determine ways of improving surgical efficiency and patient satisfaction while using less resources and wasting less time.
2. Analyze ways in which hand surgery might be a model to other specialties for the greening of surgery.

The objective of the presentation is to expose the audience to what goes into creating an organization from scratch and the risks and benefits of doing so. It will emphasize the power that each of us have in the profession of medicine. It demonstrates how if we use that power appropriately we can create messages far beyond what our clinical practices entail. That message is created by the metaphors involved in the patients that we treat that not only teach us lessons in our lives but through which we are able to teach others important lessons in life.

Objectives: Following this session, the participant will be able to:

1. Introduce the participants of the meeting to the opportunities that exists to help people in their communities and around the world who cannot afford or access such care.
2. Develop for the participant a better understanding of the world as it really exist as opposed to the way they see it on the nightly news.
3. Introduced to the group the various forms that international care can be delivered. Beginning with the mission model and ending with Comprehensive Care centers in public-private partnerships.

This course will review the indications and technique of "wide awake" surgery in the hand from the perspective of hand surgeons and hand therapists.

Objectives: Following this session, the participant will be able to:

1. Learn the indications and contraindications to wide awake surgery.
2. Learn the benefits of wide awake surgery from a surgeon's perspective.
3. Learn the benefits of wide awake surgery from a therapist's perspective.

This Instructional Course will cover the assessment of the patient with Kienbock's disease including advanced imaging and wrist arthroscopy. The latest treatment options of the management of Kienbock's Disease, including the role of Osteotomy, Vascularised bone graft and Limited wrist fusions will be discussed.

Objectives: Following this session, the participant will be able to:

1. Choose the simplest and most effective reconstructive options calibrating clinical rationale and evidence.
2. Define potential surgical complications and their risk management.
3. Describe key technical details and expected outcomes.
4. Explain how therapists adapt tasks to improve function in Kienbock's disease.

This course will cover complex vascular problems of the upper extremity, present diagnostic, and treatment dilemmas. Few hand surgeons outside of major referral centers garner extensive experience in their management. As a result many hand surgeons are not as familiar or facile with their treatment alternatives. This course will also review the pertinent vascular anatomy, with an emphasis on critical variations. Appropriate use of diagnostic testing including office based alternatives, capabilities of the vascular lab and radiographic studies will be presented. Finally, common vascular problems and their treatment options, both surgical and nonsurgical, will be reviewed utilizing a case based format.

Objectives: Following this session, the participant will be able to:

1. Understand the vascular anatomy.
2. Learn available diagnostic tests and how to order them in an appropriate and cost effective fashion.
3. Present common vascular disorders and their treatment alternatives both conservative and surgical.

The entire spectrum of scaphoid pathology will be presented from the acute fracture stage, to stable nonunions, progressing to unstable scaphoid nonunions with AVN and carpal instability (humpbacked collapse). Each of the faculty members will be presented a typical set of images from each of these various stages of scaphoid fracture pathology, and then will walk the audience through their preferred method of treatment for each of those particular stages. A combination of various treatment techniques will be presented ranging from percutaneous fixation to arthroscopic assisted internal fixation, arthroscopic guided bone grafting, and ORIF with a variety of vascularized bone grafts. A treatment continuum will be stressed, emphasizing that the selected treatment plan must be highly individualized to the patient's specific fracture / nonunion with respect to elapsed time from injury, location - waist vs. proximal pole, stability (displacement / angulation), presence of cystic resorption and proximal pole perfusion/ viability.

Objectives: Following this session, the participant will be able to:

1. Correctly identify the various stages of pathologic scaphoid fracture progression extending from the fresh fracture to the unstable nonunion with AVN and carpal instability.
2. Identify the appropriate treatment techniques or methods for each particular stage of scaphoid pathology.
3. Discuss the indications for arthroscopic assisted cancellous bone graft, open structural corticocancellous grafts, and a variety of vascularized bone grafts.
4. Discuss the unique characteristics and demands of the small proximal pole delayed union / nonunion.
5. Describe strategies to improve adherence in this population.

Congenital hand differences are challenging problems to the surgeon. A variety of reconstruction options are available with consideration of both form and function. This course will be case-based discussions of a myriad of congenital hand problems with an emphasis on surgical reconstruction.

Objectives: Following this session, the participant will be able to:

1. Describe recent advances in managing congenital hand differences.
2. Explain implications for selection, timing and rehabilitation of surgical interventions.
3. Describe expected outcomes for congenital hands.

This course will address the rationale for use of relative motion splinting that permits immediate active motion following various hand injuries and repairs. Its well-established use for long extensor repair will be discussed and reviewed, and the panelists' experience using this concept in less well-established conditions will be presented using both flexor and extensor relative motion splinting for conditions such as acute and chronic boutonniere, flexor tendon and nerve repair, acute and chronic sagittal band rupture, caput ulnar syndrome and digital joint stiffness. Participants will be encouraged to provide their input, insights and experience on the use of relative motion splinting in their own practice.

Objectives: Following this session, the participant will be able to:

1. Describe the clinical reasoning and biomechanical rationale for use of RM in the management of acute and chronic boutonniere, finger flexor tendon and nerve repairs, sagittal band injuries, zones 5-6 extensor tendon repairs, and digital joint stiffness.
2. Be confident in their implementation of RM for these conditions in their own patients.

This course will discuss methods to simplify treatment of carpal tunnel syndrome, focusing on optimizing outcomes. The role of electrodiagnostic studies, anesthetic options, and management of patients who return to the office with symptoms of CTS will be reviewed.

Objectives: Following this session, the participant will be able to:

1. Identify simple techniques and strategies that simplify conservative and surgical management of carpal tunnel syndrome.
2. Understand the role of electrodiagnostic studies in carpal tunnel syndrome.
3. Understand the difference in recurrent and persistent carpal tunnel syndrome, including reoperation.

Description Cervical spinal cord injury resulting in tetraplegia is a devastating injury with substantial limitations to independent hand and upper extremity function. Nerve transfers provide the opportunity to utilize otherwise untapped resources to restore hand function and independence. This course will present the strategies for nerve transfer in tetraplegia to improve hand function with specific focus on patient selection, surgical technique and outcomes.

Objectives: Following this session, the participant will be able to:

1. Understand the nerve transfers available in tetraplegia.
2. Define evaluation and patient selection criteria for nerve transfer.
3. Understand the surgical techniques for nerve transfer to improve hand function in tetraplegia.

8:00 am - 9:15 am	AAHS / ASPN CONCURRENT SCIENTIFIC SESSION V: Wrist/DRUJ (Main Science Room)
8:00 am - 8:05 am	Overview: Wrist David C. Ring, MD
8:05 am - 8:07 am	62. Outcomes of Free Vascularized Medial Femoral Condyle Bone Grafting for Scaphoid Nonunions David B. Jones, MD; Peter C. Rhee; Allen T. Bishop, MD; Alexander Y. Shin, MD Orthopedic Surgery, Mayo Clinic, Rochester, MN
8:07 am - 8:09 am	63. Mid-term Follow-up of Semi-constrained, Linked Total Elbow Arthroplasty in Posttraumatic Conditions Jenniefer Y. Kho, MD; Brian D. Adams, MD; Howard J. O'Rourke, MD University of Iowa, Iowa City, IA
8:09 am - 8:11 am	64. The Outcomes, Complications and Operative Times of the 1,2 Intercompartmental Supraretinacular Artery Pedicled Vascularized Bone Graft for Treatment of Scaphoid Nonunions Jessica L. Robb, MD; Michael J. Morhart, BSc, MSc, MD Plastic Surgery, University of Alberta, Edmonton, AB, Canada
8:11 am - 8:13 am	65. Long-term Outcome of the Achilles Allograft Interposition for Failed Distal Ulna Resections Dean G. Sotereanos, MD; Loukia K. Papatheodorou, MD; Benjamin G. Williams, MD Orthopaedic Specialists - UPMC, University of Pittsburgh, Pittsburgh, PA
8:13 am - 8:15 am	66. Treatment of Dorsal Intercalated Segment Instability (DISI) of the Wrist by "Overstuffing" the Scaphoid in a Cadaveric Model Anthony E. Capito, MD; James P. Higgins, MD Curtis National Hand Center, Union Memorial Hospital, Baltimore, MD
8:15 am - 8:30 am	Panel Discussion David C. Ring, MD; Jeffrey Greenberg, MD; Susan Michlovitz, PT, PhD, CHT
8:30 am - 8:35 am	Overview: DRUJ Jerry I. Huang, MD
8:35 am - 8:37 am	67. Isolated Lunotriquetral Ligament Tears Treated with Ulnar Shortening Osteotomy Ather Mirza, MD; Justin B. Mirza, DO Ather Mirza, Smithtown, NY
8:37 am - 8:39 am	68. Functional Outcome of the Distal Radioulnar Joint Replacement in Patients Younger than 40 Years Old Antonio Rampazzo, MD; Bahar Bassiri Gharb, MD; Rebecca Jones; Luis Scheker, MD Christine M. Kleinert Institute, Louisville, KY
8:39 am - 8:41 am	69. Compression Screw Fixation Without Bone Grafting For Scaphoid Fibrous Nonunion Jeremy S. Somerson, MD1; Ramesh C. Srinivasan, MD2; Daniel J. Fletcher2; Mark A. Bagg2; William C. Pederson, MD2; David Person2; Fraser J. Leversedge, MD3; David P. Green2 1Orthopaedics, University of Texas Health Science Center San Antonio, San Antonio, TX; 2Hand Center of San Antonio, San Antonio, TX; 3Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Durham, NC
8:41 am - 8:43 am	70. Osseous Anatomy of the Distal Radioulnar Joint: An Assessment Using Three Dimensional Modeling Parham Daneshvar, MD1; Ryan Willing, PhD2; Ryan Willing, Phd3; Graham King, MD4 1Orthopedic Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, ON, Canada; 2Musculoskeletal Health Research, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada; 3Hand and Upper Limb Centre, Western University, London, ON, Canada; 4Hand and Upper Limb Center, University of Western Ontario, London, ON, Canada
8:43 am - 8:55 am	Panel Discussion Jerry I. Huang, MD; Aviva Wolff, OTR, CHT
8:55 am - 8:57 am	71. The Effect of Lunate Morphology on Kienbock's Disease Peter C. Rhee, DO, MS; David B. Jones, MD; Steven L. Moran, MD; Alexander Y. Shin, MD Orthopaedic Surgery, Mayo Clinic, Rochester, MN
8:57 am - 8:59 am	72. MRI of Ulnotriquetral Ligament Split Tears: Case-control Study Michael D. Ringler, MD; Benjamin M. Howe, MD; Kimberly K. Amrami, MD; Clinton E. Hagen, MS; Richard A. Berger, MD, PhD Mayo Clinic, Rochester, MN
8:59 am - 9:01 am	73. Acute Proximal Pole Fractures of the Scaphoid Treated Non-Operatively Kristina H. Lutz, MD; Nina Suh, MD; Joy MacDermid BScPT, PhD; Ruby Grewal Hand and Upper Limb Centre, Western University, London, ON, CanadA
9:01 am - 9:03 am	74. Arthroscopic Resection Arthroplasty of the Radial Column for Scapholunate Advanced Collapse Wrist Tyson Cobb, MD1; Anna Walden, DC2; Jessica Wilt, BS3 1Director of Hand Surgery, Orthopaedic Specialists, PC, Davenport, IA; 2Clinical Research, Palmer Center for Chiropractic Research, Davenport, IA; 3Orthopaedic Specialists, Davenport, IA
9:03 am - 9:05 am	75. Treatment of Scaholunate Instability with Internal Screw fixation Christopher M. Jones, MD; Jaehon Kim, MD; Michael S. Murphy, MD Curtis National Hand Center, Union Memorial Hospital, Baltimore, MD
9:05 am - 9:15 am	Panel Discussion Jerry I. Huang, MD; Aviva Wolff, OTR, CHT
8:00 am - 9:15 am	AAHS/ ASPN CONCURRENT SCIENTIFIC SESSION VI: Nerve (Concurrent Science Room)
8:00 am - 8:05 am	Overview: Nerve Thomas B. Hughes, MD
8:05 am - 8:07 am	76. Setting Expectations Following Endoscopic Cubital Tunnel Release Tyson K. Cobb, MD1; Anna L. Walden, DC2; Jon H. Lemke, PhD3 1Director of Hand Surgery, Orthopaedic Specialists, PC, Davenport, IA; 2Clinical Research, Palmer Center for Chiropractic Research, Davenport, IA;3Biostatistics, Genesis Medical Center, Davenport, IA
8:07 am - 8:09 am	77. A Prospective, Randomized Evaluation of Endoscopic versus Open Carpal Tunnel Release in Bilateral Carpal Tunnel Syndrome Brett Michelotti, MD; Diane Romanowsky, PA-C; Randy Hauck, MD Division of Plastic Surgery, Penn State Hershey Medical Center, Hershey, PA
8:09 am - 8:11 am	78. Recovery of Monofilaments Testing in the Ring and Small Fingers after Surgical Decompression of Carpal Tunnel Syndrome Carlos Henrique Fernandes, MD; Giuseppe De Luca Jr, MD; Giselly Veríssimo de Miranda, MD; Luiz Guilherme de Saboya Lenzi, MD; Lia Meirelles, OT; João Baptista Santos, MD Universidade Federal de São Paulo, Sao Paulo, Brazil
8:11 am - 8:13 am	79. A Biomechanical Comparison of Primary Digital Nerve Repairs and CollagenTube Repairs in a Cadaveric Model Meryl Livermore, MD1; Matthew Anderson, MS2; Kyros Ipaktchi, MD1; Rodrigo Banegas, MD1 1Orthopaedics, Denver Health Medial Center, Denver, CO; 2University of California Davis, Sacramento, CA
8:13 am - 8:15 am	80. Consequences of Nerve to Nerve Tube Diameter Mismatch Jonathan Isaacs, MD; Satya Mallu, MD; Yan Wo, MD, PhD; Barrett Little, MD Department of Orthopaedics, Virginia Commonwealth University Health System, Richmond, VA
8:15 am - 8:25 am	Panel Discussion Thomas B. Hughes, MD; Sheel Sharma, MD; Steven McCabe, MD
8:25 am - 8:30 am	Overview: Nerve Jonathan Isaacs, MD
8:30 am - 8:32 am	81. Effects of Carpal Tunnel Syndrome on Precision Pinch Kinematics Raviraj Nataraj, PhD; Peter J. Evans, MD, PhD; William H. Seitz, MD; Zong-Ming Li, PhD Cleveland Clinic, Cleveland, OH
8:32 am - 8:34 am	82. Intercostal Nerve Transfer in Management of Biceps and Triceps Co-contraction in Spontaneously Recovered Obstetric Brachial Plexus Injury Ahmad Semaya, MD; Mohammed Hassan, MD; Ramy El-Nakeeb Orthopedics, Alexandria University, Alexandria, Egypt
8:34 am - 8:36 am	83. Early Results of Magnesium Metal as a Scaffold for Peripheral Nerve Regeneration Kevin Little, MD1; Tracy Hopkins2; John Vennemeyer, PhD2; Danielle Minteer3; Matt Hershcovitch, MD2; David Hom, MD2; Kacey Marra, PhD3; Sarah Pixley, PhD2 1Department of Orthopaedic Surgery, Cincinnati Children's Hospital/University of Cincinnati, Cincinnati, OH; 2Department of Cancer and Cell Bioogy, University of Cincinnati, Cincinnati, OH; 3Department of Plastic Surgery/McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA
8:36 am - 8:38 am	84. The Optimization of Peripheral Nerve Recovery Using Cortical Reorganization Techniques Bonnie Walbruch, OTR/L, CHT; Loree K. Kalliainen, MD Regions Hospital, Saint Paul, MN
8:38 am - 8:48 am	Panel Discussion Jonathan Isaacs, MD; Michael K. Obeng, MD; Ranjan Gupta, MD
8:48 am - 8:50 am	85. Effects of Corticosteroid Injection on Nerve Conduction Testing for the Diagnosis of Carpal Tunnel Syndrome Michael L. Mangonon, DO1; Owen J. Moy, MD2; James J. Kelly, DO2; Thomas B. Cowan, MD2; Dale R. Wheeler, MD2 1Plancher Orthopaedics and Sports Medicine, Orthopaedic Foundation for Active Lifestyles, Cos Cob, CT; 2Hand and Shoulder Center of Western New York, University at Buffalo, Amherst, NY
8:50 am - 8:52 am	86. Outcomes from the Addition of an Autograft and Tube Conduit Contemporary Control Cohort for RANGER®: A Registry Study of Processed Nerve Allograft Repair Outcomes Bauback Safa, MD1; Brian D. Rinker, MD2; Gregory M. Buncke, MD1 1The Buncke Clinic, San Francisco, CA; 2Division of Plastic Surgery, University of Kentucky, Lexington, KY
8:52 am - 8:57 am	87. A Comparison of Ultrasound and Electrodiagnostic Testing for the Diagnosis of Carpal Tunnel Syndrome Using a Validated Clinical Tool as the Reference Standard John Fowler, MD1; Maria Munsch, BS2; Joseph E. Imbriglia, MD2; William Hagberg, MD2 1Orthopaedic Surgery and Sports Medicine, University of Pittsburgh, Pittsburgh, PA; 2Hand and Upper Ex Center, Wexford, PA
8:57 am - 9:02 am	88. Treatment of Thoracic Outlet Compression Syndrome by Decompression of Brachial Plexus and Vessels between Cervical Foramen and Pectoralis Minor: Follow Up Study of 30 Cases Shusen Cui, MD Department of Hand Surgery, China-Japan Union Hospital, Jilin University, Jilin, China
9:02 am - 9:15 am	Panel Discussion Jonathan Isaacs, MD; Michael K Ohong, MD; Ranjan Gupta, MD

Each of the panelists has been asked to highlight their best or most important trick(s) that may not be known or utilized effectively by many practitioners of hand care. After listening to this group of well-respected experts, if the participant does not get at least one thing to improve his/her practice, he/she was just not listening!

Objectives: Following this session, the participant will be able to:

1. Take home 5 minute pearls from world hand experts with "wisdom highlights in their hair" that will likely improve their practice.
2. Be entertained by the amusement of watching the experts struggle with keeping their talks less than 5 minutes.

The conscious and unconscious sense of motion constitutes the basis of proprioception, "the sense of one self". In this lecture, the speaker will take us on a journey from the smallest sensate cell in the hand, the mechanoreceptor, to the clinical appreciation of sensorimotor function, using historical references and surgical implications to understand the sensate hand in motion.

Objectives: Following this session, the participant will be able to:

1. Define the concept of proprioception.
2. Describe the role of the mechanoreceptors and their presence in the hand/wrist.
3. Understand the interaction of proprioception and neuromuscular control.
4. Examine for upper extremity neuromuscular imbalances

Radial nerve paralysis is a relatively common condition that offers surgeons different options for operative intervention, often with favorable outcomes. This course will review time honored procedures such as nerve grafting and tendon transfers as well as newer ones involving nerve transfers. Surgical techniques, outcomes, and rehabilitation for each will be reviewed.

Objectives: Following this session, the participant will be able to:

1. Describe advantages and disadvantages of nerve grafting, nerve transfers and tendon transfers in patients with radial nerve paralysis.
2. Describe operative and postoperative techniques for nerve grafting, nerve transfers and tendon transfers in patients with radial nerve paralysis.
3. Describe outcomes associated with nerve grafting, nerve transfers and tendon transfers in patients with radial nerve paralysis.

Experienced faculty will deliver a review of commonly encountered hand and upper extremity conditions using a combination of case based presentations and lectures. They will cover principles of diagnosis and treatment, while providing an overview of conditions encountered on board examinations and resident in-training examinations. The course is ideal for residents, fellows and hand therapists who wish to increase depth of knowledge in hand surgery as well as surgeons in practice seeking a knowledge update or preparing for a MOC exam.

Objectives: Following this session, the participant will be able to:

1. Discuss non-operative and operative treatment approaches for various commonly encountered disorders of the hand and wrist.
2. Have an understanding of the different treatment options available for disorders of the hand and upper extremity.
3. Recognize various uncommon and/or unusual clinical conditions of the hand and wrist including carpal and DRUJ conditions, peripheral nerve, tendon and other common problems. Compare different treatment methods to avoid complications and improve patient outcomes.

For high ulnar, median and radial nerve injuries, distal nerve transfers in the forearm can be performed to provide motor innervation and improve functional outcomes. Reinnervation options for motor function will be described and the post operative therapy protocols and expectations will be emphasized.

Objectives: Following this session, the participant will be able to:

1. To understand the options for restoring critical motor function to the upper extremity after high ulnar, median and/or radial nerve transfers.
2. To understand the importance of timing and patient selection of nerve transfers after nerve injury.
3. To gain knowledge of the post operative therapy protocols to enhance post operative function after nerve transfers.
4. If time allows, sensory reinnervation options will also be discussed.

This course will focus on providing practical advice regarding decision-making, surgical techniques and rehabilitation protocols for adult and pediatric patients with brachial plexus palsy. Panelists will discuss their personal experience with what has worked, and importantly, what has not worked in their practice.

Objectives: Following this session, the participant will be able to:

1. Provide attendees with practical advice regarding timing of brachial plexus surgery.
2. Provide attendees with surgical solutions to the more common types of brachial plexus injuries.
3. Provide attendees with practical advice regarding post-injury and post-surgical therapy and rehabilitation.

Experienced clinical researchers will share their top tips for success in conducting clinical research embedded within clinical practice.

Objectives: Following this session, the participant will be able to:

1. Be able to select research projects that fit into your practice.
2. Describe strategies for successful collaboration on research teams.
3. Identify methods that will ensure data is analyzed correctly.
4. Identify how to achieve success and avoid pitfalls in authorship and publication.
5. Learn strategies that enhance grant success.

This session will review the non-surgical and surgical options for management of neuropathic pain/CRPS, including patient assessment and selection, surgical technique and outcomes following surgery.

Objectives: Following this session, the participant will be able to:

1. Review patient assessment and selection for surgical intervention.
2. Discuss the non-surgical and surgical options for treatment of neuropathic pain/CRPS.
3. Discuss outcomes following surgical intervention for neuropathic pain/CRPS.

This course will discuss what outcomes are and how to assess them. It will measure quality in reconstructive plastic surgery, compare effectiveness, contain cost outcomes, assess lower limb injuries, and FRAM study from PSF.

Description: Pediatric microsurgery is a highly technical area of reconstructive surgery with specific indications and issues. Microsurgical reconstruction is utilized for facial paralysis, congenital thumb absence, and trauma. The three panelists are young surgeons who have trained with top experts in the field. They will share lessons learned from their mentors and will discuss new developments in the areas of facial paralysis, free toe transfer, and nerve/flap reconstruction after trauma. Cases will be presented for discussion to highlight key principles.

10:00 am - 11:00 am	AAHS/ASPN/ASRM Joint Outstanding Papers
10:00 am - 10:07 am	AAHS #1 A 28-Day Prospective, Randomized, Double-Blind, Placebo Controlled Clinical Trial of Botulinum Toxin Type A for Raynaud's Phenomen Kelli N. Webb, MD1; Nada N. Berry1, Reuben A. Bueno1; Carisa M. Cooney2; Jennifer L. Koechle1; Michael W. Neumeister1 1Division of Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield, IL; 2Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD
10:07 am - 10:14 am	AAHS #2 Outcomes from a Multi-center, Prospective, Randomized, Blinded, Comparison Study of Processed Nerve Allografts and Hollow-Tube Conduit for Nerve Reconstructions in the Hand Brian D. Rinker, MD1; Gregory A. Merrell, MD2; S. Houston Payne Jr, MD3; E. F. Shaw Wilgis, MD4; James P. Higgins, MD4 1Division of Plastic Surgery, University of Kentucky, Lexington, KY; 2Department of Orthopaedic Surgery & Rehabilitation, Indiana Hand to Shoulder Center, Indianapolis, IN; 3Georgia Hand, Shoulder & Elbow, Atlanta, GA; 4The Curtis National Hand Center, Baltimore, MD