Preliminary Program

This course is aimed at residents, fellows, and junior attending surgeons interested in improving their understanding of nerve injury assessment, treatment principles, and repair techniques from experts in the field. The course will be divided into three parts-a didactic session to review the basic principles of nerve anatomy, physiology, nervous system response to injury, and repair strategies; small group case-based discussions to provide a "deeper dive" into the nuances of assessment, decision making, and treatment options; and finally, a hands on workshop offering an opportunity to learn and practice nerve repair techniques with some of the most accomplished experts in the field! Participants will be expected to complete the course with an enhanced understanding of nerve trauma and a greater ability to treat complex nerve injuries.

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

1. Explain the nerve anatomy, normal physiology, nerve injury, and principles of repair.
2. Describe and demonstrate the principles of nerve repair.
3. Describe and demonstrate basic techniques in nerve repair.
4. Describe and demonstrate basic techniques for assessing and surgically addressing nerve repairs with gaps.

Experienced faculty will conduct a comprehensive review of commonly encountered fractures and injuries of the hand, wrist, forearm, and elbow, employing a combination of case-based presentations and didactic lectures. The course will cover the principles of diagnosis and treatment, offering valuable surgical tips and techniques, while also addressing key conditions frequently encountered in board examinations and resident in-training assessments. Emphasis will be placed on enhancing proficiency in fracture fixation, including the selection and application of various implants. A focus on learning effective strategies for mastering implant techniques will also be integrated to support the participant's ability to navigate complex fixation scenarios. This course is ideally suited for residents, fellows, and junior faculty seeking to deepen their expertise in hand surgery, as well as practicing surgeons seeking an update in knowledge or preparing for Maintenance of Certification (MOC) examinations.

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

1. Discuss both non-operative and operative treatment approaches for a wide range of commonly encountered fractures and injuries of the hand, wrist, forearm, and elbow.
2. Identify the appropriate treatment options and available instrumentation for the management of these fractures.
3. Develop contingency strategies for addressing complex fractures and apply principles of fracture fixation to manage challenging fracture patterns.
4. Explore the opportunity to apply various implant options and fixation methods to address complex acute and delayed injuries.
5. Evaluate the benefits and limitations of different treatment modalities to minimize complications and enhance patient outcomes.

The reconstructive ladder is a well-accepted principle in hand surgery, and many impressively nuanced and technically complex regional and local flaps have been described. However, for many surgeons, clinical scenarios necessitating these techniques are rare; and simpler and more straightforward solutions are desired. This ICL will discuss principles of wound care, the role of skin substitutes in wound management, and the appropriate application of technically straightforward local and regional flaps. Therapy topics include wound care post flap, commonly used skin substitutes and tissue-based products and precautions.

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

1. Identify wounds amendable to non-operative treatment and describe the principles of wound care.
2. List the indications and contra-indications for skin substitute coverage of upper extremity wounds.
3. Describe technically straightforward and predictable local and regional flap coverage for hand and upper extremity wounds.

This session will focus on the management of post-traumatic arthritis of the proximal interphalangeal (PIP) joint, offering advanced insights for hand surgeons. Expert faculty will discuss the latest approaches in arthroplasty, joint transplantation, joint fusion, denervation, and therapy, with a focus on individualized treatment strategies. Through case-based discussions, participants will gain a deeper understanding of the indications, techniques, therapy, and outcomes associated with various interventions. Emphasis will be placed on optimizing functional recovery while minimizing complications. This symposium is ideal for surgeons seeking to refine their skills in the management of PIP joint arthritis and improve patient outcomes through advanced therapeutic options. Therapy topics include post-op rehab, orthotics and pain management, guidelines on therapy progression fusion vs arthroplasty.

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

1. List and describe the spectrum of treatment options for PIP arthritis.
2. Describe the risk: benefit ratio for PIP arthroplasty.
3. Perform PIP denervation surgery.
4. Prescribe or perform appropriate post injury or repair therapy.

This comprehensive session is designed to provide hand surgeons with a detailed exploration of scapholunate ligament injuries, from fundamental concepts to advanced management strategies. The session will delve into the complex anatomy and biomechanics of the scapholunate articulation, highlighting the critical role of this ligament in wrist stability and function. Participants will gain insights into contemporary classification systems, diagnostic algorithms, and treatment options, ranging from conservative approaches to cutting-edge surgical interventions, including both open and arthroscopic techniques. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, attendees will enhance their ability to accurately diagnose, stage, and manage the full spectrum of scapholunate ligament tears, from acute injuries to chronic instability. The course will address both primary treatment and strategies for addressing complications, including persistent instability, arthrosis, and limitations in functional outcomes. Therapy topics include S-L friendly isometrics, post-op rehab and management of chronic S-L instability.

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

1. Analyze the complex anatomy and biomechanics of the scapholunate ligament complex and apply this knowledge to accurately diagnose and classify scapholunate ligament injuries using advanced clinical examination techniques, imaging modalities, and arthroscopic evaluation.
2. Critically evaluate and implement a comprehensive range of management strategies for scapholunate ligament injuries, from conservative approaches to surgical interventions, based on evidence-based protocols and tailored to individual patient factors, injury patterns, and chronicity.
3. Compare and contrast advanced surgical techniques for scapholunate ligament repair and reconstruction, including arthroscopic methods, open approaches, and novel repair strategies, with consideration of their respective indications, technical nuances, and potential complications.
4. Develop strategies for preventing and managing complications associated with scapholunate ligament injuries and their treatments, including persistent instability, arthrosis, and failed primary interventions, incorporating both non-operative approaches and revision surgical techniques.

This session is designed to provide hand surgeons with a detailed exploration of the complex and challenging topic of ulnar-sided wrist pain. The session will begin with a comprehensive review of the relevant anatomy and biomechanics of the ulnar-sided wrist, highlighting the various structures and pathologies that can contribute to pain and dysfunction in this region. Participants will then delve into contemporary strategies for accurately diagnosing the underlying cause of ulnar-sided wrist pain, including the use of advanced imaging modalities, provocative testing, and arthroscopic evaluation. The course will then focus on evidence-based treatment algorithms, spanning conservative management approaches to cutting-edge surgical interventions for a range of ulnar-sided wrist pathologies. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, attendees will enhance their ability to develop and implement tailored treatment plans that address the unique challenges of ulnar-sided wrist pain, while also incorporating strategies for preventing and managing potential complications. Therapy topics include orthotics for pain management, activity and sport specific training and modifications.

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

1. Analyze the complex anatomy and biomechanics of the ulnar-sided wrist and apply this knowledge to accurately diagnose the underlying cause of ulnar-sided wrist pain using a comprehensive, evidence-based approach.
2. Critically evaluate and implement a range of contemporary conservative and surgical management strategies for common ulnar-sided wrist pathologies, such as ECU pathology, ulnar impaction syndrome, and DRUJ instability, based on individualized patient factors and injury patterns.
3. Compare and contrast advanced surgical techniques for addressing ulnar-sided wrist pathologies, including arthroscopic procedures, open ligament repairs and reconstructions, and joint-preserving osteotomies, with consideration of their respective indications, technical nuances, and potential complications. Differentiate post operative therapy protocols.
4. Develop comprehensive strategies for preventing and managing complications associated with the treatment of ulnar-sided wrist pain, including persistent instability, arthrosis, and failed primary interventions, incorporating both non-operative approaches and revision surgical techniques.

Lipomas are not always lipomas, enchondromas are not always enchondromas, and tendon swelling is not always just inflammation. The wrong incision, the missed biopsy, and the cavalier steroid injection can jeopardize limb salvage, worsen a patient's prognosis, or lead to dissemination of mycobacterium marinum. This ICL reviews principles of tumor assessment including which lesions need biopsies, which need referrals, and which are safe to watch. Additionally, the assessment and treatment of atypical infections will be reviewed.

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

1. Identify soft tissue and bony lesions requiring pre-surgical diagnostic workups.
2. Discuss the differences in biopsy techniques and their implications to definitive treatment.
3. Describe the characteristics and treatment principles of mycobacterium marinum and other atypical infections of the hand.

Carpal tunnel syndrome and cubital tunnel syndrome are not the only neuropathic causes of upper extremity paresthesias, weakness, and pain. The treatment of atypical nerve lesions such as radial tunnel and PIN syndromes, pronator and AIN syndromes, entrapment neuropathies around the shoulder, and Parsonage-Turner syndrome are only possible if they are recognized and appropriately evaluated. Treatment requires an understanding of their unique anatomic and pathophysiologic characteristics. Therapy topics include neuropathic pain management, pearls for treatment including myofascial pain syndrome.

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

1. List the differential diagnoses of non-carpal/cubital tunnel upper extremity entrapment neuropathies.
2. Utilize appropriate diagnostic tools to identify atypical nerve lesions in the upper extremity.
3. Describe the principles of surgical and non-surgical treatments for radial tunnel, PIN, Pronator, AIN, shoulder entrapment neuropathy, and Parsonage-Turner syndromes.

Atomic advocacy is about precision, personalization, and tenacity. Using small, specific, targeted actions towards advocacy in everything we do impacts upper extremity care. Breaking down advocacy into its smallest effective units -just like atoms in physics & chemistry-we can build a superior impact. This can occur colloquially and through atomic shifts in mindset. Specifically, through self-recognition of the value brought to each patient we treat. This talk will discuss the concept of "atomic advocacy" and the ways we see it in our routine patient care and ways we can incorporate and develop advocacy vastly for the hand surgery and hand therapy profession.

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

1. Define "atomic advocacy" and its application to upper extremity care.
2. Identify 3 micro-level advocacy actions to implement immediately.
3. Consider how advocacy at our professional level can not only impact practice, but also influence direct patient needs and help patients be advocates as well.

This session will provide an in-depth exploration of the entire spectrum of DRUJ arthritis treatment, from initial conservative approaches to complex salvage procedures. Participants will gain insights into the latest evidence-based practices, innovative surgical techniques, and decision-making strategies for optimal patient outcomes. Expert faculty will guide attendees through the nuances of diagnosis, treatment planning, and execution of various interventions. Therapy Topics include post-op rehab, return to activity and modifications for activity/sport, helpful orthotics.

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

1. Accurately diagnose DRUJ arthritis and assess its severity using clinical evaluation and imaging.
2. Develop comprehensive conservative treatment plans, including targeted physical therapy, pharmacological interventions, and orthotics.
3. Identify appropriate candidates for surgical intervention and select the most suitable procedure based on patient-specific factors.
4. Recognize and manage potential complications associated with DRUJ arthritis treatments.
5. Implement evidence-based post-operative rehabilitation protocols to optimize functional outcomes.

Scaphoid fractures can be a chip shot or a nightmare. Some scaphoid fractures offer unique challenges which can be compounded by delayed presentation, compromised bone perfusion, or end-stage avascular necrosis. Does every proximal pole need a vascularized bone graft? Can avascular bone heal with rigid fixation? What is the best strategy for reconstructing the proximal pole? Utilizing a case-based discussion format, an esteemed panel of experts will share insights, knowledge, and rationale behind a variety of treatment options. The panel will critically analyze risk: benefit ratios and debate which treatments make the most sense!

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

1. Accurately identify complex scaphoid fractures that may require advanced interventions.
2. Critically evaluate the indications and timing for escalating to more aggressive treatment modalities in scaphoid fracture management.
3. Analyze the risk-benefit ratio of advanced interventions.
4. Develop strategies to manage complications associated with advanced scaphoid fracture treatments, including nonunion, malunion, and avascular necrosis.
5. Evaluate long-term outcomes of aggressive interventions and compare them with more conservative approaches.

This session will equip hand surgeons with the knowledge and tools necessary to navigate the complex reimbursement landscape, optimize practice revenue, and maintain financial sustainability-- all while delivering high-quality patient care. Healthcare policies and reimbursement models seem to be almost constantly changing. This session will provide an overview of current reimbursement challenges and opportunities specific to hand surgery, offering practical solutions and innovative approaches to maximize revenue while ensuring compliance and ethical practice.

Objectives: By the end of this course, participants will be able to:

1. Analyze current trends in healthcare reimbursement policies and their specific impact on hand surgery practices.
2. Implement strategies to optimize coding and documentation for complex hand surgery procedures, ensuring accurate representation of services provided.
3. Evaluate and implement value-based care models and alternative payment structures relevant to hand surgery practices.
4. Develop strategies to utilize physician extenders in a fiscally positive practice model.
5. Analyze the cost-effectiveness of various treatment options and their impact on overall practice reimbursement.
6. Identify and optimize direct revenue opportunities and enhance workflow efficiency for Advanced Practice Providers (APPs) working within a hand surgery practice.

This comprehensive session will equip hand surgeons with advanced knowledge and skills to confidently manage the entire spectrum of radiocarpal arthritis cases, from initial conservative approaches to complex surgical interventions and long-term patient care. Participants will explore a comprehensive approach to treatment, ranging from conservative care strategies to the latest innovative surgical solutions. The course will provide an in-depth examination of evidence-based practices, emerging technologies, and advanced surgical techniques specific to radiocarpal arthritis management.

Objectives: By the end of this course, participants will be able to:

1. Accurately diagnose and stage radiocarpal arthritis using clinical evaluation methods and advanced imaging techniques.
2. Develop comprehensive conservative treatment plans, including targeted physical therapy, pharmacological interventions, and innovative non-surgical modalities.
3. Evaluate the efficacy of various conservative treatments and determine appropriate timelines for progression to surgical interventions.
4. Review advanced surgical techniques for radiocarpal arthritis, including arthroscopic debridement, arthrodesis, and arthroplasty.
5. Develop strategies to manage complications associated with both conservative and surgical treatments of radiocarpal arthritis.

Mangled hands, finger and limb amputations, and complex soft tissue loss represent some of the most challenging and overwhelming surgical scenarios upper extremity surgeons can encounter. Understanding and appreciating the risk: benefit ratios of all practical and available options is critical in optimizing functional outcomes following these devastating injuries. However, this level of knowledge accumulates only with many years of practice and is often concentrated within a few major trauma centers. A select group of delegates from our 2026 guest society, the Taiwan Society for Surgery of the Hand, have generously offered to share their unique expertise with us in what promises to be one of the highlight sessions of our annual meeting.

Objectives: By the end of this course, participants will be able to:

1. Identify which upper extremity amputations are replantable.
2. Describe multiple reconstructive strategies for degloving hand injuries.
3. List the basic surgical steps to achieve opposition of the reconstructed thumb.
4. Treat PIP contractures complicated by volar soft tissue loss.

Objectives: By the end of this course, participants will be able to:

1. Discuss the long term outcomes of MFT flap reconstruction of scaphoid nonunion, Kienbock's and capitate AVN.
2. Learn the anatomic and surgical challenges of Vascularized cartilage transfer for different carpal surfaces.
3. Discuss the current indications and contraindications for cartilage transfer procedures for wrist reconstruction

How do we best serve the amputee patient? Does everyone need TMR? Does everyone need a myoelectric prosthesis? Are hand transplants still a viable option? The contemporary landscape for hand amputees seems to be constantly evolving. This panel will discuss the most recent advances in prosthetic technology, hand transplant, and therapy while offering a balanced perspective on more conventional options. Therapy topics include post-op amputee management, therapy for TMR and peri-prosthetic training.

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

1. Compare and contrast the roles of hand transplant and myoelectric prostheses for the upper extremity amputee.
2. Identify which patients will benefit from (and which do not need) TMR.
3. Describe advancements and ongoing technologic obstacles in prosthetic development.

Collagenase was supposed to change the treatment paradigm for Dupuytren's contractures when introduced in 2010. Percutaneous needle fasciotomy saw a concurrent resurgence. Yet, after 15 years many patients and surgeons still opt for open surgical treatments. Have the less invasive procedures not lived up to their expectations or have surgical approaches evolved as well? This session will tackle these controversial questions and offer evidence and experience-based guidance on navigating the myriad of treatment options. The session will include a critical analysis of the roles of splinting and therapy in optimizing outcomes. Therapy topics include therapy management post collagenase/manipulation, aponeurectomy, and fasciectomy; orthotics and timelines.

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

1. Identify Dupuytren's contractures amendable to non-surgical treatment modalities.
2. List the indications/contraindications for needle fasciotomies/collagenase injections.
3. Discuss the risk: benefits of different treatment strategies including fasciectomy/skin grafting/open palm techniques.
4. Incorporate dynamic external fixators, splinting, and therapy into pre- and post-operative treatment plans.
5. Identify key patient selection indicators and procedural considerations for collegnase injection for Dupytren's Disease.

Despite decades of research and an ever-increasing awareness of the accepted principles of nerve surgery, the needle on nerve repair outcomes has not moved much. Axonal loss, perineural scarring, and time dependent denervation atrophy seem to still be daunting obstacles to clinical recovery. Over the last several years, the medical industry has offered many solutions- coaptation aids to improve nerve end alignment, scar barriers and wraps to enhance the local microenvironment and inhibit neural adhesions, nerve electrical stimulation protocols to accelerate axon regeneration, and muscle stimulation to preserve muscle integrity and prevent denervation atrophy. None of these tools are cheap and the benefits are often theoretical and poorly substantiated. While nothing is more expensive than a failed surgery, do these products live up their hype? This session will offer an honest and critical analysis of many of the recently introduced products and attempt to answer the complex and daunting question, "are any of them worth the money?"

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

1. Identify the practical and physiological obstacles to clinical recovery following nerve injury.
2. Describe the currently accessible adjuvant therapies designed to improve outcomes in nerve injury patients.
3. Critically analyze the available data on electrical stimulation of nerve and denervated muscle.
4. Discuss the potential benefits/risks of nerve coaptation aids.
5. Describe the rationale and expected efficacy of commercially available nerve wrap options.

This interactive breakout session focuses on an in-depth exploration of elbow rehabilitation, pathology, and treatment strategies. Participants will develop advanced clinical reasoning skills and evidence-based treatment approaches for the challenging stiff elbow, integrating upper extremity function and occupational performance outcomes.

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

1. Identify key anatomical structures contributing to elbow function and dysfunction.
2. Recognize clinical presentations and underlying pathophysiology of the stiff elbow.
3. Demonstrate evidence-based joint mobilization techniques for elbow restrictions.
4. Discuss how to appropriately integrate soft tissue treatment approaches for elbow impairments.
5. Demonstrate how to select, fabricate and fit orthotic devices to optimize elbow function and healing.
6. Design progressive exercise programs targeting elbow mobility, strength, and function.

This case-based course is designed specifically for nurse practitioners (NPs) and physician assistants (PAs) working in hand surgery. Through a dynamic, case-based format, participants will explore high-stakes clinical scenarios where recognition and timely intervention are critical to treatment. Content will center on real-world case presentations that highlight "can't-miss" diagnoses, emphasizing crucial decision-making moments, diagnostic pitfalls, and urgent management strategies. Key diagnoses, treatment interventions, and management strategies will also be discussed. This course will enhance diagnostic judgement, improve interdisciplinary communication, and strengthen clinical confidence in critical situations. Participants will engage in imaging reviews and surgical decision-making pathways tailored to their scope of practice.

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

1. Identify the hallmark signs and symptoms of critical hand and upper extremity conditions.
2. Interpret imaging and physical exam findings to prioritize emergent vs. urgent interventions.
3. Discuss the pathophysiology and clinical progression of critical hand diagnoses.
4. Apply best practices in treatment and management for time-sensitive conditions.
5. Familiarize yourself with more atypical, unusual presentations.

The Surgical Skills Cadaveric Workshop is an advanced educational program designed to provide participants with comprehensive instruction in internal fixation techniques and critical technical insights for the management of wrist and hand fractures and hand and wrist arthritis. This course is facilitated by a panel of distinguished faculty experts and incorporates a hands-on practical component utilizing cadaver models to reinforce theoretical concepts.

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

1. Apply and execute, using cadaver models, the fundamental principles of lag screw fixation, neutralization plating, and compression plating techniques in the context of hand fractures.
2. Accurately identify various fracture patterns of the distal radius, formulate appropriate reduction strategies, and perform volar plating procedures on cadaver specimens.
3. Critically evaluate and implement surgical interventions for the management of arthritis conditions of the hand and wrist

This unique and dynamic course will feature speakers presenting key components of return to sport, performance and work from APP and CHT specialists. Topics covered range from conversations about return-to-sport, the mental preparation of return-to-work, and initiating the strengthening process to evidence based strategies for guiding musicians through safe return- to-play and a comprehensive framework for safe return-to-work following traumatic or repetitive upper extremity injury. The return-to-sport component will provide a comprehensive overview of the initial conversation with school and recreational athletes to outline the essential steps for the return to participation or competition following an upper extremity injury. The initial strengthening component will cover utilization of a progressive exercise program including proprioception, dynamic stabilization, isokinetic and isotonic activities to aide in recovery. The return-to-play and performance segment will explore evidence-based strategies for guiding musicians through safe return-to-play and preventing performance-related injuries. The return-to-work segment will focus on coaching patients through mental rehabilitation after upper extremity injury and go beyond strength and ROM to outline a comprehensive framework for safe return-to-work in the upper extremity that integrates objective clinical benchmarks, kinetic chain stability, workplace adaptation, and psychosocial factors.

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

1. Analyze risk factors for musician injuries and apply graded rehabilitation and return-to-play protocols in clinical practice.
2. Outline the essential steps involved in safely returning school and recreational athletes to sports after injury.
3. Identify key talking points with setting patient expectations regarding recovery and return-to-work following upper extremity injury.
4. Develop a progressive exercise program for common wrist conditions.
5. Integrate a unified framework to optimize safe and sustainable return-to-work outcomes for patients with upper extremity conditions.

Neuropathic pain is one of the most challenging sequelae of nerve trauma, advanced entrapment neuropathy, and perineural cicatrix. Revision surgery, neurolysis, or transposition are not always successful or practical. This ICL explores the spectrum of non-operative and operative treatments including pharmacologic options, physical therapy modalities, scar barriers, electrical stimulation (percutaneous and implantable), and neuroma reconstruction. Therapy topics include conservative and post-op approaches to nerve pain including modalities, neuroma management and pain neuroscience education.

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

1. List the pharmaceutical options used to treat nerve pain.
2. Describe the surgical options and their risks and benefits for recalcitrant nerve pain.
3. Prescribe or apply available physical therapy modalities used to treat nerve pain.

This advanced session is designed to provide hand surgeons with a comprehensive update on state-of-the-art techniques in flexor tendon repair and management of associated complications. The session will explore recent advancements in surgical approaches, biomechanical considerations, and post-operative protocols. Emphasis will be placed on evidence-based strategies to optimize functional outcomes and mitigate common complications. Through a combination of didactic presentations, case-based discussions, and interactive problem-solving exercises, participants will enhance their clinical decision-making skills and surgical proficiency in managing complex flexor tendon injuries. Therapy topics include post-op flexor tendon rehab, orthotics, appropriateness of protocols (which and when) and timeframes for activity advancement.

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

1. Critically evaluate and implement contemporary surgical techniques for flexor tendon repair, including advanced suture configurations and biomechanically optimized repair strategies.
2. Analyze and apply current evidence-based post-operative rehabilitation protocols to maximize functional outcomes while minimizing the risk of repair failure or adhesion formation.
3. Identify and manage common complications associated with flexor tendon repair, including tendon re-rupture, adhesion formation, and stiffness, through both conservative and surgical interventions.
4. Formulate comprehensive treatment plans for complex flexor tendon injuries, incorporating strategies for addressing concomitant pulley injuries, neurovascular structures, and surrounding soft tissues.

The radial nerve is vulnerable to iatrogenic injury and avulsing trauma related to humerus, radial neck, and both bone forearm fractures. Historically a "watch and wait" approach was often recommended. However, contemporary thinking suggests that the prognosis for spontaneous recovery is not as good as once thought and many patients would benefit from earlier intervention. This ICL will discuss the assessment, decision tree, and available treatment options including functional splinting, nerve reconstruction, tendon transfers, and nerve transfers. Therapy topics include timeframe for radial nerve palsy orthotics, types of orthotics and decision making for which orthotic to use with each pt, post-op radial nerve tendon transfer and nerve transfer rehab pearls.

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

1. Assess a patient with radial nerve palsy.
2. List the available surgical and non-surgical options.
3. Describe the principles and basic surgical steps to radial palsy nerve and tendon transfers.

This advanced session is designed to provide hand surgeons with a comprehensive analysis of current approaches to the management of proximal interphalangeal (PIP) joint fracture dislocations. The session will explore recent advancements in diagnostic modalities, surgical techniques, and rehabilitation protocols. Emphasis will be placed on evidence-based strategies to optimize functional outcomes and address challenging complications. Through a combination of expert presentations, case-based discussions, and interactive problem-solving exercises, participants will enhance their clinical decision-making skills and surgical proficiency in managing these complex injuries. The course will cover a spectrum of injury patterns, from acute management to salvage procedures for chronic instability and post-traumatic arthritis. Therapy topics include orthotics including traction devices, post-op rehab, maximizing PIP motion while preventing extensor lag.

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

1. Critically evaluate and implement contemporary diagnostic and treatment algorithms for various patterns of PIP joint fracture dislocations, including the selection of appropriate conservative and surgical interventions based on fracture morphology and joint stability.
2. Analyze and apply advanced surgical techniques for PIP joint fracture dislocations, including volar plate arthroplasty, dynamic external fixation, and internal fixation methods, with consideration of their respective biomechanical principles and clinical outcomes.
3. Develop comprehensive management strategies for complications associated with PIP joint fracture dislocations, including chronic instability, stiffness, and post-traumatic arthritis, incorporating both non-operative and surgical approaches.
4. Formulate evidence-based post-operative rehabilitation protocols tailored to specific injury patterns and surgical interventions, with the goal of optimizing range of motion and minimizing complications such as contracture and extensor lag.

Research is the cornerstone of the hand surgery knowledgebase and is vital for the continued advancement of our specialty. Setting up a lab or even incorporating clinical research into a busy practice can seem overwhelming. This ICL will provide practical insights into the successful incorporation of research into your practice including how and where to find funding, establishing and running a basic sciences lab, organizing and leading clinical research, and building a supportive team for sustained success. Therapy topics include orthotics including traction devices, post-op rehab, maximizing PIP motion while preventing extensor lag.

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

1. List available funding sources for basic science and clinical hand and upper extremity research.
2. Describe key aspects to developing and running a basic science lab.
3. Identify meaningful clinical research opportunities and build a collaborative research team.

This advanced session is designed to provide hand surgeons with a comprehensive analysis of less frequently encountered carpal instabilities, focusing on lunotriquetral (LT), perilunate, perilunate nondissociative, and midcarpal instabilities. The session will explore current diagnostic approaches, biomechanical considerations, and surgical and non-surgical treatment strategies for these complex wrist pathologies. Emphasis will be placed on evidence-based management protocols and innovative surgical techniques. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, participants will enhance their ability to recognize, accurately diagnose, and effectively treat these challenging conditions. The course will address both acute and chronic presentations, as well as strategies for managing associated complications and sequelae. Therapy topics include isometrics for stability and orthotics for minimizing pain and maximizing function with carpal instability.

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

1. Differentiate and accurately diagnose various forms of less common carpal instabilities, including LT, perilunate, perilunate nondissociative, and midcarpal instabilities, through advanced clinical examination techniques and appropriate imaging modalities.
2. Critically evaluate and implement contemporary treatment algorithms for each type of carpal instability, incorporating both conservative management and surgical interventions based on the specific pathoanatomy, chronicity, and patient factors.
3. Analyze and apply advanced surgical techniques for the management of these carpal instabilities, including arthroscopic approaches, ligament reconstruction, capsulodesis procedures, and salvage options.
4. Develop comprehensive strategies for preventing and managing complications associated with these carpal instabilities and their treatments.

This comprehensive session is designed to provide hand surgeons with an in-depth analysis of Scapholunate Advanced Collapse (SLAC) wrist, encompassing its pathoanatomy, progression, and the full spectrum of management options. The session will explore current understanding of SLAC wrist biomechanics, natural history, and decision-making algorithms for treatment. Emphasis will be placed on evidence-based strategies ranging from non-operative management to various surgical interventions, including proximal row carpectomy (PRC), interposition arthroplasty, partial wrist fusions, arthroscopic techniques, and wrist denervation. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, participants will enhance their ability to formulate comprehensive treatment plans tailored to individual patient needs and disease stages. The course will address both primary management and strategies for dealing with complications and failed interventions.

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

1. Analyze the pathoanatomy and biomechanical progression of SLAC wrist and apply this knowledge to accurately stage the condition and inform treatment decisions, incorporating advanced imaging techniques and clinical assessment methods.
2. Critically evaluate and implement a comprehensive range of management strategies for SLAC wrist, including evidence-based non-operative approaches, indications for various surgical interventions, and appropriate patient selection criteria for each treatment modality.
3. Compare and contrast the technical aspects, biomechanical considerations, and long-term outcomes of different surgical options for SLAC wrist, including PRC, interposition arthroplasty, partial wrist fusions (such as four-corner fusion and STT fusion), arthroscopic management, and wrist denervation procedures.
4. Develop strategies for preventing and managing complications associated with SLAC wrist and its treatments, including persistent pain, impaired function, hardware-related issues, and progression of arthrosis, incorporating both non-operative approaches and revision surgical techniques.

Distal radius fractures are one of the most common injury patterns treated by hand surgeons. Over the last 20 years, the volar plate has come to reign supreme in the surgeon's arsenal. Yet, despite their popularity, volar plates are not without risk and may not be the best option for every fracture pattern. This ICL will offer insights to successful volar plating, review alternative treatment techniques including bridge plating, and discuss strategies for dealing with complications including median neuropathy, malpositioned hardware, and malunion. Therapy Topics include outcomes for rehab vs no rehab, which patients benefit most from therapy visits vs HE.

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

1. List the indications for volar vs bridge plating in the treatment of distal radius fractures.
2. Recognize distal radius fracture complications and describe strategies to avoid and address these complications.
3. Discuss available modalities to optimize post-surgical results and to mitigate the sequela of related complications associated with distal radius fractures.

This advanced course is designed to provide hand surgeons with a comprehensive analysis of the long-term sequelae associated with extensor tendon injuries in the hand. The session will explore the complex interplay of anatomical, biomechanical, and functional factors that contribute to suboptimal outcomes following both conservative and surgical management of these injuries. Emphasis will be placed on evidence-based strategies for prevention, early recognition, and management of complications such as adhesions, tendon ruptures, joint contractures, and extensor lag. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, participants will enhance their ability to critically evaluate and manage challenging cases of extensor tendon dysfunction. The course will cover a spectrum of sequelae, from minor functional deficits to severe deformities, and will address both non-operative and surgical approaches to reconstruction and salvage procedures. Therapy topics include post-op management of extensor tendon reconstruction and cases of different types of extensor reconstruction.

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

1. Analyze the pathomechanics and natural history of extensor tendon injury sequelae in the hand, incorporating advanced understanding of tendon healing, adhesion formation, and the impact on joint biomechanics to inform clinical decision-making and treatment planning.
2. Critically evaluate and implement contemporary strategies for preventing and managing common sequelae of extensor tendon injuries, including evidence-based rehabilitation protocols, early intervention techniques, and indications for secondary surgical procedures.
3. Compare and contrast advanced surgical techniques for addressing complex extensor tendon dysfunction, including tenolysis, tendon reconstruction, capsulotomy, and arthroplasty, with consideration of their respective outcomes, limitations, and potential complications.
4. Develop comprehensive management plans for challenging cases of extensor tendon sequelae, incorporating both non-operative and surgical approaches, and addressing associated complications such as joint stiffness, swan neck and boutonnière deformities, and impaired hand function.

This comprehensive course is designed to provide hand surgeons with an in-depth exploration of traumatic Triangular Fibrocartilage Complex (TFCC) tears, spanning from fundamental concepts to advanced management techniques. The session will delve into the complex anatomy, biomechanics, and pathophysiology of TFCC injuries, emphasizing accurate diagnosis and classification. Participants will gain insights into contemporary treatment algorithms, ranging from conservative approaches to cutting-edge surgical interventions, including both open and arthroscopic techniques. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, attendees will enhance their ability to manage the full spectrum of TFCC injuries, from simple tears to complex instabilities. The course will address both acute and chronic presentations, as well as strategies for preventing and managing associated complications. Special attention will be given to emerging technologies, evidence-based practices, and techniques for optimizing long-term functional outcomes. Therapy topics include rehab post TFCC injury and repair, timeframe for orthotics and motion advancement, return to activity and sport, modifications for work and sport.

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

1. Analyze the complex anatomy and biomechanics of the TFCC and apply this knowledge to accurately diagnose and classify traumatic TFCC tears using advanced clinical examination techniques, imaging modalities, and arthroscopic evaluation.
2. Critically evaluate and implement a comprehensive range of management strategies for traumatic TFCC tears, from conservative approaches to surgical interventions, based on evidence-based protocols and tailored to individual patient factors, injury patterns, and chronicity.
3. Compare and contrast advanced surgical techniques for TFCC repair and reconstruction, including arthroscopic methods, open approaches, and novel fixation strategies, with consideration of their respective indications, technical nuances, and potential complications.
4. Develop strategies for preventing and managing complications associated with TFCC injuries and their treatments, including persistent instability, stiffness, and failed primary interventions, incorporating both non-operative approaches and revision surgical techniques.

This comprehensive refresher course is designed to update and enhance the knowledge and skills of adult hand surgeons in managing pediatric hand and upper extremity fractures. The session will provide a thorough review of the unique aspects of pediatric skeletal anatomy, growth, and healing processes, emphasizing how these factors influence fracture patterns, treatment decisions, and long-term outcomes. Participants will explore contemporary management strategies for common and complex pediatric fractures, including both conservative and surgical approaches. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, attendees will refine their ability to diagnose, classify, and treat pediatric fractures while considering age-specific considerations and potential complications. The course will address recent advances in pediatric fracture care, including minimally invasive techniques, novel fixation methods, and evidence-based protocols for optimizing functional outcomes and minimizing growth disturbances. Therapy topics include pediatric specific rehab and which patients need more intervention.

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

1. Analyze the unique anatomical, physiological, and biomechanical characteristics of the pediatric skeletal system, and apply this knowledge to accurately diagnose, classify, and develop appropriate treatment plans for pediatric hand and upper extremity fractures.
2. Critically evaluate and implement contemporary management strategies for pediatric fractures, ranging from conservative approaches to surgical interventions, with consideration of age-specific factors, fracture patterns, and potential impact on growth and development.
3. Compare and contrast advanced techniques for pediatric fracture fixation, including percutaneous pinning, intramedullary nailing, and external fixation, with emphasis on minimizing growth plate disturbances and optimizing long-term functional outcomes.
4. Develop comprehensive strategies for preventing and managing complications associated with pediatric fractures, including malunion, growth arrest, and post-traumatic deformities, incorporating both non-operative approaches and surgical reconstruction techniques.
5. Discuss conservative management strategies as well as highlight when to refer/key "can't miss" presentations which would prompt surgeon referral.

Few topics in hand and peripheral nerve surgery are as controversial as Thoracic Outlet Syndrome (TOS). Many surgeons do not think it exists, and, for others, the lack of objective diagnostic criteria is at least concerning. Surgical approaches seem to range from minimally invasive to extensive and aggressive. This ICL will offer diagnostic guidance, present non-surgical modalities, and describe the surgical principles commonly utilized in treating TOS. Therapy Topics include rehab principles, what to strengthen and what to lengthen, positions/activities to avoid and successful return to activity/work/sport.

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

1. Describe and understand an algorithmic approach to diagnosing TOS.
2. Prescribe or apply non-surgical treatment modalities for suspected TOS.
3. Describe the principles of surgical treatment for recalcitrant TOS.

Post-paretic synkinesis remains an unsolved clinical problem with major functional and psychosocial consequences in both adult and pediatric populations. A multidisciplinary approach has been shown to offer hope for substantial improvement. This includes targeted facial therapy, thoughtful neuromodulation with Botox, and innovative, selective surgery based on clinical and electromyography (EMG) findings. This course will discuss the underlying pathophysiology, clinical presentation, and management of post-paretic synkinesis in both adult and pediatric populations.

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

1. Describe the pathophysiological mechanisms of synkinesis following facial nerve injury.
2. Recognize the clinical manifestations and be able to appropriately anticipate synkinesis.
3. Describe treatment approaches, including facial therapy, neuromodulation, and selective surgical techniques.
4. Apply multidisciplinary strategies to optimize outcomes for patients with facial synkinesis.

Many commonly accepted principles in peripheral nerve surgery are rooted in decades-old studies, anecdotal experiences, and selectively interpreted data. This instructional course invites participants to critically examine the basic science that underpins some of the most enduring surgical dogmas-questioning what still holds true, what requires re-evaluation, and what may be impeding innovation. Attendees will gain insight into the laboratory models, early experiments, and translational research that shaped current paradigms - some of which remain robust, while others may be overdue for revision.

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

1. Discuss the historical and experimental origins of key concepts in peripheral nerve surgery.
2. Critically appraise the quality and relevance of foundational basic science studies that have shaped current surgical dogma.
3. Distinguish between evidence-supported practices and tradition-driven assumptions.
4. Explore new directions in nerve biology research that challenge or refine established norms.

In hand surgery, as in all medicine, expertise is both a privilege and a paradox. The very knowledge and skills that allow us to operate with confidence can also make us vulnerable to blind spots, biases, and outdated assumptions. Drawing inspiration from Adam Grant's Think Again and Daniel Kahneman's Thinking, Fast and Slow, this keynote will explore how surgeons can cultivate humility and intellectual flexibility without sacrificing decisiveness in the operating room. We will examine the tension between intuition and analysis-between the rapid, experience-driven judgments that guide our hands and the deliberate, slower thinking that challenges our assumptions. By embracing the discipline of "rethinking," we can learn not only to update our technical skills, but also to renew our perspective on patient care, teamwork, and our own professional wellbeing. This session will call on us to view lifelong learning not as an obligation, but as a source of resilience, meaning, and inspiration. By fostering curiosity, openness, and humility, we honor both our patients and the generations of surgeons who will follow. Attendees will leave encouraged to ask better questions, embrace uncertainty as a catalyst for growth, and reimagine mastery not as knowing more, but as being willing to learn-always.

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

1. Recognize how cognitive biases and overconfidence can affect surgical decision-making and patient outcomes.
2. Apply strategies from Think Again and Thinking, Fast and Slow to balance intuitive expertise with deliberate reflection in clinical practice.
3. Embrace lifelong learning and humility as essential elements of surgeon wellbeing, patient care, and professional growth.

This comprehensive session will equip participants with knowledge, and decision-making frameworks to confidently navigate the most challenging ulnar nerve reconstruction cases. Participants will explore a comprehensive, case-based approach to ulnar nerve management, covering a wide range of surgical techniques, including nerve transfers, tendon transfers, and nerve reconstruction. Led by a distinguished faculty of renowned hand surgeons, this session will provide an in-depth examination of evidence-based practices, innovative surgical solutions, and decision-making strategies for optimal patient outcomes. Therapy topics include post-op rehab for ulnar nerve recon, tendon transfers or nerve transfers with therapy pearls, timeframes, use of orthotics and DAFRA program highlights.

Objectives: By the end of this course, participants will be able to:

1. Accurately diagnose and assess the severity of ulnar nerve pathology.
2. Develop comprehensive treatment plans, considering the unique patient factors and functional demands.
3. Discuss various surgical techniques for ulnar nerve reconstruction, including nerve transfers, tendon transfers, and nerve grafting.
4. Identify appropriate candidates for each surgical intervention and select the most suitable approach based on the specific case.
5. Implement evidence-based post-operative rehabilitation protocols to optimize functional outcomes following ulnar nerve reconstruction and tendon transfers.

This dynamic course will combine relevant hand therapy literature, research principles and clinical practice in an interactive trivia-style format. Bring your “A” game in research knowledge and current literature as these “D” (doctorate) faculty coach us through evidence evaluation, real-work application and implications to better our practice.

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

1. Recognize red flags in research methodology and overgeneralized conclusions when critiquing sources of evidence.
2. Identify treatment approaches that have changed in therapy practice as evidence has evolved.
3. Evaluate evidence for significant outcomes to implement change in clinical practice.

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 the 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. Identify 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.
4. Compare different treatment methods to avoid complications and improve patient outcomes.

This comprehensive course is designed to provide hand surgeons with an in-depth analysis of the full spectrum of management options for thumb carpometacarpal (CMC) joint arthritis. The session will explore current understanding of CMC joint biomechanics, disease progression, and decision-making algorithms for treatment. Emphasis will be placed on evidence-based strategies ranging from minimally invasive approaches such as denervation and arthroscopy to more traditional interventions like trapeziectomy, and extending to advanced techniques including implant arthroplasty. Through a combination of expert lectures, case-based discussions, and interactive problem-solving exercises, participants will enhance their ability to critically evaluate and implement appropriate treatment strategies tailored to individual patient needs and disease severity. The course will address both primary management and approaches for dealing with complications and failed interventions, providing a thorough overview of contemporary practice in this challenging area of hand surgery. Therapy topics include what does rehab look like and how does it differ based on surgical procedure, timeframe for orthotics, strengthening/dynamic stabilization and return to activity.

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

1. Critically evaluate the current evidence base for various treatment modalities in thumb CMC arthritis, including denervation, trapeziectomy with or without ligament reconstruction and tendon interposition (LRTI), arthroscopic techniques, and implant arthroplasty, and apply this knowledge to develop patient-specific treatment algorithms.
2. Compare and contrast the technical aspects, biomechanical considerations, and long-term outcomes of different surgical options for thumb CMC arthritis, with particular emphasis on the advantages and limitations of each approach in different clinical scenarios.
3. Analyze and implement advanced surgical techniques for managing thumb CMC arthritis, including arthroscopic procedures, various methods of trapeziectomy and LRTI, and current implant arthroplasty options, with consideration of proper patient selection, surgical planning, and potential pitfalls.
4. Develop comprehensive strategies for preventing and managing complications associated with thumb CMC arthritis treatments, including implant failure, instability, impingement, and persistent pain, incorporating both non-operative approaches and revision surgical techniques.

Hyper-selective denervation has emerged as an exciting new treatment for spasticity. However, for many of us, the learning curve has been painfully steep. More conventional treatments including tenotomy, tendon lengthening, and tendon transfers definitely still have a role. This ICL will discuss patient selection, the nuances of denervation procedures, the role of therapy and splinting, and offer practical algorithms for this challenging problem. Therapy topics include rehab pearls post denervation, tenotomy, tendon lengthening and tendon transfers.

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

1. Identify patients who might benefit from hyper-selective denervation.
2. Describe the surgical technique and appropriate application of hyper-selective denervation for muscle spasticity.
3. Compare and contrast conventional surgical and nonsurgical treatments for muscle spasticity.
4. Incorporate therapy protocols into treatment algorithms for muscle spasticity.

There are few decision trees more challenging than failed nerve surgery. Persistent symptoms following nerve decompression may be related to inadequate release, iatrogenic impingement, recurrent scarring, or poor nerve recovery despite adequate release. Nerve repairs as well are sometimes not successful. This ICL will discuss the assessment tools, timing, and decision tree for re-exploration and treatment of failed carpal tunnel releases, cubital tunnel releases, and nerve repairs. The therapist role in assessing and managing these complex patients will be explored as well. Therapy topics include tips and tricks to maximize symptom management, red flags in therapy and when to refer back to the surgeon.

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

1. Identify the potential causes of failed nerve decompression and repair.
2. List and describe the available assessment tools including physical exam, ultrasound, MRI, and nerve conduction studies.
3. Differentiate treatment options for failed nerve decompression and repair including the proper use of scar barriers, nerve transfers, and re-do nerve reconstruction.

Modern surgical practice demands more than clinical excellence-it requires mastery of time. Between operating room schedules, clinic responsibilities, administrative tasks, research, and teaching, many surgeons find themselves overextended and under-supported. This instructional course is designed to equip busy surgeons with practical, high-impact strategies for reclaiming control of their time and streamlining day-to-day operations. This course will focus on foundational time management principles tailored to the realities of surgical life, including calendar architecture, task triage, boundary setting, and strategic delegation. Common pitfalls and productivity myths will be addressed with evidence-based guidance. This course will also discuss how artificial intelligence can serve as a powerful assistant for the modern surgeon.

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

1. Identify common time management challenges unique to surgical practice and develop strategies to address them.
2. Apply practical tools and systems for organizing clinical, academic, and administrative responsibilities.
3. Evaluate current AI technologies that can support surgeons in documentation, communication, and planning tasks.
4. Design a personalized workflow that incorporates both human and digital support to optimize professional performance and well-being.

When primary nerve reconstruction fails to restore shoulder function in brachial plexus injury (BPI), secondary management becomes critical. This instructional course provides an exploration of shoulder reconstruction strategies in both pediatric and adult patients following incomplete or failed nerve reconstruction. Faculty will address the unique challenges of shoulder dysfunction in this context, including glenohumeral joint dysplasia in children, fixed contractures, muscle atrophy, and joint instability in adults. Surgical options such as tendon transfers, external rotation osteotomies, scapulothoracic fusion, and joint stabilization techniques will be discussed, along with non-operative approaches to maximize shoulder utility. Participants will learn to select appropriate secondary procedures based on residual motor function, joint status, and patient-specific needs. The course will also cover timing of intervention, imaging, and rehabilitation strategies.

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

1. Identify common patterns and causes of failed shoulder reinnervation in brachial plexus injury.
2. Evaluate the full spectrum of reconstructive options for shoulder management after unsuccessful nerve reconstruction.
3. Develop an approach to surgical decision-making for management of the shoulder in brachial plexus injury. Integrate postoperative therapy and orthotic management to optimize outcomes.

Trauma, infection, oncologic and other pathology challenge the reconstructive surgeon. Surgery may result in less function, more pain or other unintended adverse outcomes. The panelists will highlight challenging cases that led them to change practice, innovate, and strive to do better next time. Teaching points: how plans can be derailed by unexpected events and how this sparks innovation. From our failures, we can learn to better help others in the future!

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

1. Discuss critical decision-making in complex surgical pathology.
2. Recognize pitfalls in surgical technique or treatment planning.
3. Develop strategies to troubleshoot complications and effective disclosure to patients.
4. Discuss thoughtful evaluation of outcomes and the impetus to change and innovate