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.

This session will explore the expanding role of arthroscopy across the upper extremity, highlighting emerging applications in the shoulder, elbow, wrist, and small joints of the hand. Faculty will review indications, patient selection, surgical techniques, and current evidence supporting arthroscopic management of conditions including instability, cartilage injury, stiffness, arthritis, and fracture-related pathology. Comparisons between arthroscopic and open approaches will emphasize clinical outcomes, soft-tissue preservation, rehabilitation, and complication avoidance. The course will also examine evolving technologies, reconstructive strategies, and future innovations that continue to advance minimally invasive upper-extremity surgery.

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

1. Describe emerging applications of arthroscopy in upper-extremity surgery, including the shoulder, elbow, wrist, and small joints of the hand.
2. Identify indications, contraindications, and patient selection criteria for advanced arthroscopic procedures involving the upper-extremity joints.
3. Evaluate the advantages and limitations of arthroscopic versus open surgical techniques with respect to visualization, soft tissue preservation, rehabilitation, and clinical outcomes.
4. Interpret current evidence supporting arthroscopic management of complex upper-extremity conditions, including instability, cartilage injury, stiffness, arthritis, and fracture-related pathology.
5. Discuss evolving arthroscopic technologies and instrumentation that are expanding the role of minimally invasive surgery in upper-extremity reconstruction.
6. Recognize technical challenges, complications, and risk-avoidance strategies associated with advanced arthroscopic procedures of the shoulder, elbow, wrist, and hand.
7. Develop treatment algorithms incorporating arthroscopic techniques for the management of common and complex upper-extremity disorders.

Flap coverage is essential for management of wounds in the hand and upper extremity. Options for coverage often rely on surgeon preference and can include complex and personalized options that may not be the first choice for many scenarios. This session will focus on principles of wound coverage as well as workhorse local, regional and free flaps applied to typically encountered clinical scenarios.

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

1. Describe principles for management of wounds along the reconstructive ladder.
2. List indications for local, regional and free flap coverage of hand and upper extremity wounds.
3. Discuss workhorse local flap options for coverage of hand and upper extremity wounds.
4. Discuss workhorse regional flap options for coverage of hand and upper extremity wounds.
5. Discuss workhorse free flap options for coverage of hand and upper extremity wounds.

This session will examine contemporary decision-making in the management of distal radius fractures, focusing on when to observe, fix, or incorporate wrist arthroscopy. Participants will review patient-specific and fracture-specific factors that influence treatment selection, including fracture morphology, instability patterns, age, activity level, and functional demands. Current evidence comparing nonoperative management, open reduction and internal fixation, and arthroscopy-assisted techniques will be discussed, with emphasis on outcomes, associated intra-articular injuries, and complication avoidance. Through case-based discussions, attendees will develop practical treatment algorithms and strategies to support evidence-based, shared decision-making for a wide range of distal radius fracture presentations.

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

1. Evaluate patient-specific and fracture-specific factors that influence the decision between operative and nonoperative management of distal radius fractures.
2. Interpret radiographic and advanced imaging findings to identify fracture characteristics associated with instability, displacement, and potential functional impairment.
3. Compare outcomes of nonoperative treatment, open reduction and internal fixation, and arthroscopy-assisted management for common distal radius fracture patterns.
4. Identify indications for wrist arthroscopy in the assessment and treatment of associated intra-articular injuries, including ligamentous and chondral pathology.
5. Assess the role of fracture morphology, patient age, activity level, and functional demands in selecting the optimal treatment strategy.
6. Develop evidence-based treatment algorithms for acute distal radius fractures ranging from minimally displaced injuries to complex intra-articular fractures.
7. Recognize complications and pitfalls associated with observation, fixation, and arthroscopy-assisted techniques, and implement strategies to optimize outcomes.
8. Apply contemporary evidence to shared decision-making discussions regarding operative versus nonoperative management of distal radius fractures.

This session will provide a practical and systematic framework for evaluating and managing ulnar-sided wrist pain, one of the most challenging complaints encountered in hand and wrist surgery. Participants will review the clinical presentation, physical examination findings, imaging studies, and arthroscopic findings associated with common conditions involving the TFCC, distal radioulnar joint, ulnocarpal articulation, ECU tendon, pisotriquetral joint, and carpal stabilizers. Emphasis will be placed on simplifying the diagnostic process through evidence-based algorithms that distinguish among osseous, ligamentous, tendinous, and articular sources of pain. Treatment strategies, diagnostic pitfalls, and individualized management plans will be discussed to help optimize patient outcomes and streamline clinical decision-making.

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

1. Develop a systematic approach to the evaluation of ulnar-sided wrist pain, incorporating relevant history, physical examination findings, and diagnostic testing.
2. Differentiate common causes of ulnar-sided wrist pain, including pathology involving the TFCC, distal radioulnar joint, ulnocarpal articulation, extensor carpi ulnaris tendon, pisotriquetral joint, and carpal instability.
3. Interpret radiographs, CT scans, MRI studies, and wrist arthroscopy findings to accurately diagnose conditions affecting the ulnar side of the wrist.
4. Identify key clinical examination maneuvers that help distinguish among osseous, ligamentous, tendinous, and articular sources of pain.
5. Compare nonoperative and operative treatment strategies for common causes of ulnar-sided wrist pain based on patient characteristics and underlying pathology.
6. Apply evidence-based treatment algorithms to simplify diagnostic and management decisions in patients presenting with ulnar-sided wrist complaints.
7. Recognize diagnostic pitfalls and overlapping conditions that may contribute to persistent or recurrent symptoms.
8. Develop individualized management plans that optimize function, pain relief, and return to activity while minimizing unnecessary interventions.

Benign and malignant masses in the hand are commonly encountered by hand surgeons. While the majority of masses may be managed nonoperatively, a smaller proportion may require surgical intervention. This course will focus on diagnosis and management of masses from typical to atypical. Principles for biopsy and management of atypical and malignant lesions will be discussed as well as indications for referral to an oncologist.

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

1. Describe diagnosis and management of common hand masses.
2. Identify symptoms and signs suggestive of an atypical or malignant hand mass that require further diagnostic workup.
3. Discuss principles for biopsy of suspicious hand masses.
4. Discuss strategies for management or referral of malignant hand masses.

Carpal and cubital tunnel syndrome are common conditions encountered by all hand surgeons. This session will focus on state-of-the-art strategies for diagnosis and management of carpal and cubital tunnel syndrome. Principles of ultrasound for diagnosis will be discussed. Current and new surgical strategies including open, endoscopic, minimally invasive and ultrasound guided approaches will be discussed. Current areas of focus in research will be covered.

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

1. Discuss current strategies for diagnosis and management of carpal and cubital tunnel syndrome.
2. List principles of ultrasound for diagnosis of carpal and cubital tunnel syndrome.
3. Appreciate current and emerging surgical techniques for treatment of carpal and cubital tunnel syndrome.
4. Understand new areas of research relating to carpal and cubital tunnel syndrome.

Upper extremity care often begins with a hand, wrist, elbow, or shoulder diagnosis, but recovery is shaped by far more than tissue healing alone. This presentation explores how pain beliefs, fear avoidance, strength, nutrition, lifestyle habits, connection, and gratitude influence function, participation, and long-term health. Grounded in the themes of lifestyle, leadership, and longevity, the talk invites hand therapists, surgeons, and the broader hand care team to consider how small, evidence-informed conversations can support recovery, resilience, and whole-person health.

Surgical management of spasticity is one of the rapidly changing and expanding fields in hand surgery. This panel will cover traditional techniques such as tendon transfer and tenotomies and newer surgical techniques such as hyperselective neurectomies and nerve transfers for management of spasticity. Perspectives from an international panel of surgeons with different approaches and techniques will be presented.

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

1. Identify patients with spasticity that will benefit from surgical intervention.
2. Describe indications and surgical techniques for tendon transfer, tendon lengthening, tenotomy.
3. Describe indications and surgical techniques for selective and hyperselective neurectomies and nerve transfers.
4. Appreciate variations in practice for surgical treatment of spasticity around the world.

Surgical management of scaphoid nonunion continues to be a controversial and rapidly evolving field. In this panel, different approaches and philosophies for management of scaphoid nonunion will be presented and discussed. Cases will be presented to show successful and failed reconstructions. Controversies will be discussed. What cases benefit from vascularized bone and cartilage grafting? Do newer techniques for fixation such as dual screws and plates make a difference? When should reconstruction be abandoned and salvage procedures performed? Finally, evolving and new techniques from an international panel will be discussed.

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

1. Identify indications for surgical treatment of scaphoid nonunion.
2. Evaluate indications for reconstruction with nonvascularized techniques.
3. Discuss indications for reconstruction with advanced microsurgical techniques.
4. Appreciate scenarios where salvage surgery should be performed.

Hand surgery education focuses on diagnosis and treatment of patients but often neglects details relating to running a business. In this session, a panel of surgeons in academic and private practice will discuss pearls and pitfalls for keeping a practice profitable. The financial, operational and administrative aspects of running an upper extremity medical practice will be reviewed. Details relating to coding and billing will be discussed. Tips for optimizing efficiency in running a practice will be discussed, including revenue cycle management, practice operations, ancillary services and strategies for growth.

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

1. Discuss principles for managing financial, operational and administrative aspects of an upper extremity practice.
2. Appreciate differences in a hand surgery practice between academic and private practice settings.
3. Discuss common pearls for coding and billing in hand surgery.
4. Appreciate strategies for optimizing revenue and streamlining workflow efficiency.

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

1. Trace the conceptual origins of the total Distal Radioulnar Joint (DRUJ) prosthesis, including the anatomic and biomechanical rationale and the unmet clinical need that motivated its development.
2. Identify the principal challenges and obstacles encountered during the design and development process, encompassing engineering, biomechanical, material, and clinical considerations.
3. Describe the strategies and design solutions employed to overcome these challenges and to translate the initial concept into a functional, implantable device.
4. Summarize the regulatory pathway and interactions with the U.S. Food and Drug Administration (FDA) required to achieve approval for clinical use in patients.
5. Apply lessons learned from this experience to formulate practical recommendations for surgeons seeking to develop and bring their own innovations to fruition.

The introduction of dual mobility thumb CMC prostheses into the USA represents one of the biggest paradigm shifts for management of thumb CMC arthritis. This panel will discuss the history, development and current applications for implant arthroplasty in thumb CMC arthritis. Surgical details and outcomes will be discussed with use of single and dual mobility prostheses. Strategies for management of recurrence and complications will be discussed from the British experience.

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

1. Appreciate the historical development of implant arthroplasty for thumb CMC arthritis.
2. Understand published long-term outcomes of joint replacement for thumb CMC arthritis.
3. Identify indications and contraindications for implant arthroplasty.
4. Describe surgical principles for use of a dual mobility prosthesis in the thumb.
5. Appreciate strategies for management of recurrence and complications in implant arthroplasty for thumb CMC arthritis.

Techniques for reconstruction of complex and composite defects in the hand and upper extremity continue to evolve. In this panel, a group of expert reconstructive surgeons will discuss cutting edge techniques for surgical planning, flap coverage and nerve management through a case-based approach. A holistic approach for reconstruction in the hand and upper extremity will be presented to guide hand surgeons in leveling up their surgical approaches and techniques.

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

1. Appreciate principles of surgical planning for reconstruction of the mangled hand and complex upper extremity wounds.
2. Discuss techniques for nerve and neuroma management in upper extremity wounds.
3. Describe advancements and new techniques for coverage of soft tissue defects in the hand and upper extremity.

This session will focus on the evaluation and management of distal radioulnar joint (DRUJ) instability, emphasizing the complex interplay between osseous alignment and soft tissue stabilizers. Participants will learn to distinguish radius-based and ulna-based causes of instability through clinical assessment and advanced imaging, while developing a systematic approach to diagnosis and treatment planning. Discussion will highlight the importance of restoring radial alignment, the role of ulna-directed procedures, and decision-making for acute versus chronic instability patterns. Through case-based review and current evidence, attendees will develop practical algorithms to determine when correction of the radius, ulna, or both is required to restore DRUJ congruity, stability, and function while minimizing complications.

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

1. Recognize the osseous and soft tissue contributors to distal radioulnar joint (DRUJ) instability and understand their impact on forearm and wrist function.
2. Differentiate radius-based and ulna-based pathologies that lead to DRUJ instability through clinical examination and imaging assessment.
3. Interpret radiographic, CT, and advanced imaging findings to identify malalignment, deformity, and instability patterns affecting the DRUJ.
4. Evaluate the role of radial alignment restoration in the treatment of acute and chronic DRUJ instability associated with distal radius fractures and malunions.
5. Assess indications for ulna-focused procedures, including ulnar shortening osteotomy, corrective ulnar osteotomy, ulnar head reconstruction, and salvage techniques.
6. Compare treatment algorithms for acute versus chronic DRUJ instability, incorporating patient-specific factors, injury patterns, and functional demands.
7. Develop evidence-based surgical treatment plans for complex cases of DRUJ instability by determining when correction of the radius, ulna, or both is necessary to restore joint congruity and stability.
8. Identify common pitfalls and complications associated with operative management of DRUJ instability and strategies to optimize outcomes.

This course provides hand therapists with a practical approach to the evaluation and management of common shoulder conditions. Participants will review shoulder anatomy and biomechanics, learn key assessment techniques, differentiate common diagnoses based on clinical findings, and explore evidence-informed treatment strategies to improve upper extremity function and patient outcomes.

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

1. Analyze shoulder anatomy and biomechanics as they relate to upper extremity function and dysfunction.
2. Select and interpret clinical examination findings to support differential diagnosis of common shoulder disorders.
3. Design individualized rehabilitation programs utilizing current evidence and best practices for management of common shoulder conditions.

Join experienced hand surgery APPs for an interactive, case-based session highlighting common and challenging clinical scenarios encountered in everyday practice. Through real-world interactive discussion, faculty will walk through the evaluation, diagnostic workup, treatment options, and clinical decision-making behind each case. The session will conclude with a rapid-fire exchange of practical "tips and tricks," where each faculty member shares a favorite clinical pearl, workflow strategy, or lesson learned that has improved efficiency, patient care, or professional success as a hand surgery APP. Attendees will leave with immediately applicable knowledge and practical insights to enhance their own clinical practice.

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

1. Apply evidence-based clinical decision-making to common and complex hand surgery cases.
2. Differentiate treatment options and recognize controversies in the management of upper extremity conditions.
3. Identify practical clinical pearls that improve patient evaluation, diagnosis, and management in the outpatient and inpatient settings.
4. Incorporate workflow strategies and "tips and tricks" shared by experienced hand surgery APPs to improve efficiency and confidence in clinical practice.
5. Engage in interactive case discussions to strengthen clinical reasoning and problem-solving skills.

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 course will provide a multidisciplinary review of common hand tendon pathologies through the combined perspectives of Advanced Practice Providers and Certified Hand Therapists. APP faculty will focus on the clinical presentation, physical examination, diagnostic workup, nonoperative and operative treatment options, and recognition of complications associated with various flexor and extensor tendon disorders. Hand therapists will discuss postoperative rehabilitation protocols, splinting techniques, edema control, tendon gliding, scar management, and strategies to optimize functional recovery. Through collaborative discussion and case-based learning, participants will gain a comprehensive understanding of the continuum of care for hand tendon injuries and conditions.

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

1. Recognize the clinical presentation and physical examination findings associated with common flexor and extensor tendon disorders of the hand.
2. Differentiate operative and nonoperative treatment strategies for a variety of hand tendon injuries and tendinopathies.
3. Identify common complications associated with hand tendon pathology, including stiffness, adhesions, deformity, rupture, and tendon imbalance.
4. Discuss postoperative rehabilitation principles, splinting strategies, and therapy protocols utilized in the management of hand tendon injuries.
5. Apply a multidisciplinary approach to the evaluation, treatment, and rehabilitation of patients with hand tendon disorders through collaboration between APPs and hand therapists.

Teams join forces with AAHS mentors for trivia questions on a range of topics, loosely related to hand surgery. Open to residents, fellows, candidate members and members in their first 3 years of practice.

Evolving techniques for management of finger fractures have provided more options for surgical fixation. In particular, the recent popularization of intramedullary nails has changed the way that many fractures are treated. In this session, contemporary techniques and cases will be presented to provide a problem-solving approach to help with decision making in management of finger fractures, from simple to complex.

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

1. Understand different techniques for management of finger fractures.
2. Appreciative different fracture patterns and configurations that would benefit from fixation with nails, plates or K wires.
3. Develop management strategies for treatment of simple, complex and multiple finger fractures.
4. Formulate rehabilitation protocols tailored to different finger fracture patterns and types.

This session will provide a comprehensive update on current and evolving techniques for primary and delayed flexor tendon repair as well as complications. New technologies and techniques as well as up to date rehabilitation protocols will be presented. The panel will discuss their current management as well as tips and tricks for management of a variety of flexor tendon injuries. Through a combination of didactic presentations, case discussions and problem-solving exercises, participants will emerge better equipped to manage flexor tendon injuries.

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

1. Evaluate different surgical techniques for flexor tendon repair.
2. Understand application of new devices for flexor tendon repair.
3. Appreciate current state of research on advances in flexor tendon repair.
4. Manage complications associated with primary and delayed flexor tendon repair.
5. Identify rehabilitation strategies for postoperative management of different flexor tendon injuries.

This session will review contemporary approaches to the management of complex elbow trauma, including fracture-dislocations, severe articular comminution, and associated soft tissue injuries. Participants will explore advanced imaging techniques, evolving concepts in elbow stability restoration, and current reconstructive options ranging from fixation and internal joint stabilization to acute arthroplasty in select cases. Emphasis will be placed on balancing stable reconstruction with early motion to maximize function while minimizing stiffness and other complications. The course will also highlight emerging technologies, biologic adjuncts, and patient-specific planning strategies that are shaping the future of complex elbow trauma care and improving long-term outcomes.

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

1. Develop a contemporary framework for evaluating complex elbow trauma ("smashed elbow"), including fracture-dislocations, articular comminution, and associated soft tissue injuries.
2. Interpret advanced imaging (CT with 3D reconstruction and adjunct MRI when indicated) to characterize fracture patterns and associated ligamentous injury about the elbow.
3. Compare current operative strategies for complex elbow reconstruction, including fixation techniques, external fixation, internal joint stabilization, and acute arthroplasty where appropriate.
4. Evaluate evolving concepts in elbow stability restoration, including the role of the collateral ligaments, coronoid reconstruction, and restoration of the trochlear notch.
5. Assess indications for early motion protocols versus protected immobilization, balancing stability with prevention of post-traumatic stiffness.
6. Review emerging technologies and techniques anticipated to influence elbow trauma care in 2027, including improved fixation constructs, biologic augmentation, and patient-specific planning tools.
7. Recognize complications of complex elbow trauma management, including stiffness, heterotopic ossification, instability, and post-traumatic arthritis, and implement strategies to mitigate risk.
8. Formulate evidence-based, individualized treatment algorithms for high-energy elbow injuries to optimize functional outcomes and long-term joint preservation.

Nerve and tendon transfers represent a cornerstone for reconstruction of the traumatized extremity. In this panel, contemporary strategies for management of the traumatized upper and lower extremity will be discussed. An evidence-based approach will be presented to guide the use of nerve and tendon transfers following different nerve injuries, tendon injuries and composite injuries involving multiple tissue types. Current rehabilitation strategies to optimize clinical outcomes will be presented.

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

1. Understand the role of established and new nerve transfers for reconstruction of injuries in the upper and lower extremity.
2. Understand the role of tendon transfers for reconstruction of the injured upper and lower extremity.
3. Develop strategies for incorporating nerve and tendon transfers into clinical practice.
4. Appreciate the role of rehabilitation strategies in optimizing clinical outcomes following nerve and tendon transfer.

Research in hand surgery is essential for advancing the way that we diagnose and treat patients. In this panel, fundamentals for setting up a lab, getting funding and getting started with clinical research will be presented. An expert panel of surgeon scientists will share their experience about incorporating research into their practice and building a team for continued success. Advances in hand surgery and exciting areas of research in our specialty will be discussed.

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

1. Discuss strategies for starting up a basic science lab or clinical research program.
2. Understand mechanisms of grant funding available to hand surgeons.
3. Appreciate techniques for incorporating research into clinical practice.

This session will provide a practical, evidence-based approach to the diagnosis and management of carpal instability, emphasizing the recognition of both dynamic and static patterns of carpal malalignment. Participants will review the clinical examination, provocative testing, and imaging findings associated with scapholunate, lunotriquetral, midcarpal, and perilunate instability, while developing strategies to accurately assess injury severity and chronicity. Current treatment options, ranging from nonoperative management and ligament repair to reconstructive procedures and salvage techniques, will be discussed in the context of patient-specific factors and functional demands. Through case-based review and contemporary evidence, attendees will learn treatment algorithms designed to restore wrist stability, preserve motion, and reduce the risk of progressive degenerative arthritis.

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

1. Develop a structured approach to the evaluation of carpal instability, integrating history, physical examination, and provocative testing.
2. Differentiate patterns of carpal instability, including scapholunate, lunotriquetral, midcarpal, and perilunate instability, based on clinical and radiographic findings.
3. Interpret standard radiographs, dynamic imaging, CT, and MRI findings to identify static and dynamic carpal malalignment.
4. Recognize the spectrum of ligamentous injury severity, from partial tears to chronic dissociation and carpal collapse patterns.
5. Compare nonoperative and operative treatment strategies for acute, subacute, and chronic carpal instability.
6. Evaluate current reconstructive options, including ligament repair, ligament reconstruction, capsulodesis, partial wrist fusions, and salvage procedures.
7. Identify factors that influence outcomes, including chronicity of injury, reducibility, cartilage status, and patient-specific functional demands.
8. Apply evidence-based algorithms to improve functional outcomes, minimize progression to degenerative wrist arthritis, and optimize long-term wrist stability

Artificial intelligence has revolutionized the way that we process information and provides new avenues for diagnosing and treating patients in hand surgery. In this panel, the impact of technology and artificial intelligence on clinical practice in areas ranging from clinical diagnosis, review of radiographs, ultrasound and minimally invasive surgery will be discussed. The role of artificial intelligence in the process of paper submission, peer review and academic medicine will be discussed. New developments in technology for rehabilitation of patients will be reviewed.

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

1. Appreciate the role of technology and artificial intelligence in clinical practice.
2. Understand the impact of technology and artificial intelligence on peer-reviewed journals and academic medicine.
3. Identify opportunities for technology and artificial intelligence in rehabilitation of hand patients.

The hardest thing in surgery is to decide when not to operate. Hand surgery continues to advance at an incredible pace, with new surgical techniques often mirroring the Gartner Hype Cycle. In this panel, a group of expert surgeons discusses operations that they no longer perform as well as experience that led to this evolution in clinical practice.

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

1. Discuss the role of the hype cycle in evolution of surgical techniques in hand surgery.
2. Identify previous surgical procedures that are no longer routinely performed.
3. Appreciate the evolution of surgical techniques in different fields in hand surgery.

This panel brings together hand surgeons working in underserved communities across South Florida and the Caribbean to share their experiences firsthand. Panelists will discuss strategies and challenges in caring for these populations while highlighting the local cultures and communities of our host region, in keeping with the values and mission of the IDEA Committee.

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

1. Identify common barriers to hand surgery care in underserved communities, including cultural, socioeconomic, and systemic factors.
2. Describe practical approaches to delivering equitable, culturally responsive care.
3. Apply community-based practice strategies to improve access and outcomes in their own setting.
4. Reflect on the hand surgeon's role in health equity and community engagement.

Patients presenting with atraumatic vascular disorders of the hand are often treated medically for a prolonged period of time before being referred for surgical intervention. In this course, workup and patient selection for vasospastic and vaso-occlusive disorders of the hand will be reviewed. Nonsurgical intervention including botulinum toxin injection and therapy options will be discussed. Surgical options including sympathectomy and vascular reconstruction will be reviewed.

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

1. Understand strategies for diagnosis and workup of patients with vasospastic and vaso-occlusive disorders of the hand.
2. Discuss current indications and techniques utilizing botox injections in treatment of vasospastic disorders of the hand.
3. Appreciate therapy options for treatment of patients with vasospastic and vaso-occlusive disorders of the hand.
4. Describe surgical strategies for reconstruction in vasospastic and vaso-occlusive disorders of the hand.

Treatment of patients with neuropathic pain is challenging. The peripheral component of the pain is often complicated by central sensitization in patients with chronic pain. This course will explore causes and workup of neuropathic pain as well as the range of nonoperative and operative treatment including medications, therapy options, electrical stimulation and surgical treatment of neuromas. A holistic approach will be presented to optimize treatment for patients with nerve pain.

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

1. Discuss causes of neuropathic pain.
2. Describe pharmaceutical options for treatment of neuropathic pain.
3. List therapy modalities for treating nerve pain.
4. Appreciate different surgical strategies for treatment of neuropathic pain.

Denervation provides new, less invasive options for surgical treatment of chronic joint pain as a bridge between conservative treatment options and arthroplasty or arthrodesis. While initially popularized for treatment of radiocarpal arthritis, new techniques are available for treatment of chronic joint pain in other areas. This ICL will discuss the anatomic basis of denervation and current surgical strategies for treatment of elbow, wrist, thumb and small joint arthritis and pain.

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

1. Discuss the anatomical basis of denervation for chronic joint pain.
2. Appreciate surgical techniques utilizing denervation for treatment of chronic elbow pain.
3. Appreciate surgical techniques utilizing denervation for treatment of chronic wrist pain.
4. Appreciate surgical techniques utilizing denervation for treatment of chronic small joint pain.

This session will focus on the evaluation and surgical management of distal radius malunions, with emphasis on understanding deformity patterns and selecting the optimal corrective strategy. Participants will learn to classify extra-articular and intra-articular malunions, assess the functional consequences of deformity, and develop comprehensive preoperative plans for correction. The course will review volar, dorsal, and radial-sided osteotomy techniques, including fixation methods, grafting considerations, and management of complex multiplanar deformities. Indications, contraindications, expected outcomes, and salvage options will also be discussed to help surgeons determine when corrective osteotomy is appropriate and when alternative treatment strategies may provide better patient outcomes.

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

1. Define and classify the different types of distal radius malunions, distinguishing intra-articular from extra-articular deformities and characterizing the planes of deformity (dorsal angulation, radial shortening, loss of radial inclination, and intra-articular incongruity).
2. Describe the surgical technique for volar approach correction of distal radius malunion, including osteotomy planning, fixation strategies, and the role of structural versus non-structural bone grafting.
3. Describe the surgical technique for dorsal approach correction of distal radius malunion, including indications for a dorsal opening-wedge osteotomy and considerations for extensor tendon management.
4. Describe the surgical technique for correction of radial-sided and combined-plane malunions, including radial column osteotomy and approaches to multiplanar deformity.
5. Identify the contraindications to corrective osteotomy and recognize the clinical scenarios in which accepting the deformity, or pursuing salvage alternatives, represents the more appropriate management strategy.

The spectrum of pediatric hand surgery is wide, and most often treated by specialized pediatric hand surgeons. However, every hand surgeon will encounter pediatric cases in clinical practice. This course will focus on common pathology related to congenital and traumatic hand conditions. Pearls for diagnosis and treatment of patients will be presented and discussed by a panel of specialized pediatric hand surgeons.

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

1. Appreciate common congenital hand differences encountered by hand surgeons.
2. Appreciate common traumatic hand conditions in pediatric patients encountered by hand surgeons.
3. Discuss treatment of common congenital hand differences.
4. Discuss treatment of common pediatric hand trauma pathology.

While surgical treatment of tetraplegia has focused traditionally on tendon transfers, newer techniques incorporating nerve transfers have become popular. This course will focus on comprehensive treatment of patients requiring upper extremity reconstruction in tetraplegia. Workups and selection of patients who would benefit from surgery will be discussed. Traditional and newer surgical options will be presented to guide state-of-the-art surgical treatment for patients with tetraplegia.

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

1. Discuss indications for upper extremity surgery in patients with tetraplegia.
2. Appreciate tendon transfer options for surgery in tetraplegia.
3. Appreciate nerve transfer options for surgery in tetraplegia.
4. Describe new advances relating to upper extremity reconstruction for tetraplegia.

This session will review minimally invasive techniques for nerve surgery and technologies to improve the safety of these procedures. The speakers on this panel will review a variety of specific applications for minimally invasive techniques.

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

1. Discuss how to balance patients' desire for small incisions and minimal downtime with surgical safety
2. Recognize when minimally invasive techniques are or are not indicated
3. Understand specific technical pearls for implementation of minimally invasive techniques

Thoracic outlet syndrome can be difficult to diagnose and even more difficult to manage. This session will address diagnostic pearls, surgical indications, unique features for adolescent patients, controversies in management, and emerging surgical techniques.

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

1. Discuss the diagnostic options for thoracic outlet syndrome and the pitfalls associated with these diagnostic tests
2. Understand the pros and cons of rib resection and pectoralis minor release
3. Appreciate the variety of surgical techniques available for management of thoracic outlet syndrome

The lecture highlights the remarkable influence and contributions immigrant women physicians made to the advancement of American medical education and healthcare. Immigrant hand surgeons are featured, highlighting the groundbreaking innovations they introduced to their field that are still benefiting patients today. The lecture emphasizes that embracing diversity and inclusivity policy by the AAHS towards its members has been the secret sauce for its success and benefited this organization and its members.

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

1. Examine the evolution of medical thought across multiple periods of history.
2. Explore American medical history from colonial time into turn of the century.
3. Appreciate the status of immigrant physicians in refining U.S. healthcare.
4. Highlight the role immigrant women physicians played in advancing medicine.
5. Discover the gift of knowledge immigrant hand surgeons gave to their field.
6. Know the significance of immigration for cultural & technological development.
7. Acknowledge the significance of diversity and inclusivity for U.S. superiority

Peripheral nerve surgery is undergoing rapid evolution, with ongoing debate regarding optimal treatment strategies for nerve injuries, compression neuropathies, and painful neuromas. Emerging techniques such as nerve transfers, targeted muscle reinnervation (TMR), regenerative peripheral nerve interfaces (RPNI), and processed nerve allografts have expanded reconstructive options but continue to generate questions regarding indications, timing, outcomes, and cost-effectiveness. This session will review the current evidence, highlight areas of controversy, and provide practical guidance for decision-making in complex upper-extremity nerve disorders.

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

1. Determine when nerve transfers should replace traditional nerve grafting.
2. Critically evaluate whether TMR should be performed prophylactically at the time of amputation.
3. Assess the evidence supporting RPNI versus TMR for prevention and treatment of symptomatic neuromas.
4. Debate the role of processed nerve allografts versus autografts for mixed and motor nerve defects.
5. Examine whether supercharged end-to-side (SETS) nerve transfers improve outcomes in severe cubital tunnel syndrome and proximal ulnar neuropathy.
6. Evaluate indications for revision decompression and nerve wrapping procedures in recurrent compression neuropathies.
7. Analyze the cost-effectiveness and clinical value of emerging biologic and implantable technologies in peripheral nerve reconstruction.

This session provides hand therapists, hand surgeons, and upper-extremity rehabilitation professionals with a practical framework for differentiating acute and chronic edema from primary and secondary lymphedema. Participants will review relevant pathophysiology, risk factors, clinical presentation, objective measurement methods, tissue characteristics, and functional implications of upper-extremity swelling. Emphasis will be placed on examination findings that help distinguish expected postoperative edema from presentations that warrant modification of rehabilitation interventions, medical reassessment, or referral for specialized lymphedema care.
Evidence-informed management approaches will be discussed, including positioning, elevation, active motion, compression, manual edema mobilization, scar management, skin protection, patient education, and home-program development. The session will introduce principles of basic upper-extremity lymphedema bandaging, including indications, precautions, materials, layering concepts, pressure gradients, and patient monitoring. Attention will also be given to red flags, including infection, vascular compromise, complex regional pain syndrome, deep vein thrombosis, progressive neurologic symptoms, and suspected lymphedema requiring interdisciplinary management. Through case-based clinical reasoning, participants will gain strategies to optimize tissue mobility, functional recovery, and safe interdisciplinary care for patients with upper-extremity edema and lymphedema.

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

1. Differentiate common postoperative and traumatic upper-extremity edema from primary and secondary lymphedema using patient history, distribution of swelling, tissue characteristics, and clinical presentation.
2. Perform and interpret an upper-extremity swelling assessment using objective measurement methods, skin and tissue examination, range-of-motion assessment, scar mobility, sensory findings, and functional performance measures.
3. Explain the effects of edema and lymphedema on wound healing, scar maturation, tendon gliding, joint mobility, peripheral nerve symptoms, pain, and hand function.
4. Select appropriate edema-management interventions within hand therapy practice, including positioning, elevation, active motion, compression, manual edema mobilization, scar management, and patient education.
5. Demonstrate the principles and basic application of upper-extremity lymphedema bandaging, including appropriate material selection, layering sequence, pressure-gradient concepts, safety precautions, and patient monitoring.

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.

Carpal and cubital tunnel syndrome are the most commonly encountered sites of nerve compression in the upper extremity. Often atypical compression neuropathies such as thoracic outlet syndrome, quadrilateral space, suprascapular nerve entrapment, radial tunnel syndrome, pronator syndrome and ulnar tunnel syndrome are misdiagnosed or diagnosed late. This course will focus on simplifying the diagnosis and treatment of atypical compression neuropathies. Therapy options will be presented and discussed.

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

1. List the differential diagnosis for atypical compression neuropathies in the upper extremity.
2. Discuss tools for workup and diagnosis of atypical nerve compression sites in the upper extremity.
3. Appreciate surgical treatment options for thoracic outlet syndrome, shoulder entrapment neuropathies, radial tunnel, pronator tunnel and ulnar tunnel syndrome.

Every hand surgeon will encounter at some point a patient with a mangling hand injury requiring urgent surgical intervention. In this course, tips and tricks for managing the hand will be presented using a case-based approach. Holistic management strategies incorporating primary and secondary reconstruction strategies will be presented. Tips and tricks will be discussed to optimize initial management and final surgical outcomes.

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

1. Appreciate initial treatment strategies for management of the mangled hand.
2. Discuss principles for staged reconstruction in mangling hand injuries.
3. Describe holistic treatment strategies for optimizing outcomes in mangling hand injuries.

Patients presenting after failed nerve surgery are difficult to manage. Persistent symptoms relating to pain, paresthesias and motor weakness may relate to failed nerve decompression or failed nerve reconstruction. In this course, strategies for assessment as well as timing of intervention will be discussed for re-exploration and treatment of failed carpal and cubital tunnel decompression and nerve repair. Up-to-date surgical techniques for treatment of nerve gaps and persistent, recurrent or new symptoms after initial surgical treatment of carpal and cubital syndrome will be discussed.

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

1. Identify causes of failed nerve decompression and nerve repair.
2. Discuss tools for assessment including physical examination, electrodiagnostic studies, ultrasound and MRI.
3. Appreciate surgical strategies for treatment of persistent, recurrent or new symptoms in carpal and cubital tunnel syndrome.
4. Appreciate surgical strategies for treatment of nerve gaps after failed primary nerve repair.

While restoration of motor function is often a focus, restoration of sensory function is very important to patients and important for maximizing function. The experts on this panel will address sensory reinnervation across a variety of issues and indications.

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

1. Discuss the importance of sensation in real-world function
2. Understand the indications and techniques for sensory restoration
3. Recognize opportunities to improve sensory outcomes

Management of facial nerve palsy continues to evolve, now with multiple approaches available to improve facial function. This panel will discuss options available for early and late management of facial nerve palsy.

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

1. Describe the procedures available for treatment of facial nerve palsy
2. Understand the indications for facial nerve palsy procedures
3. Discuss technical pearls for the procedures to treat facial nerve palsy

During this session, participants will learn basics of using ultrasound, perforator mapping with an ultrasound, lymphatic mapping with an ultrasound, how to use ultrasound in breast reconstruction practice for implant surveillance/seroma/hematoma, and postoperative use of ultrasound.

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

1. Describe the basic physics, knobology, and probe selection relevant to point-of-care ultrasound in reconstructive microsurgery practice.
2. Perform perforator mapping with ultrasound, including identification of vessel course, caliber, and depth to optimize flap design and operative efficiency.
3. Apply ultrasound techniques for lymphatic mapping and channel selection to guide lymphaticovenous anastomosis and related procedures.
4. Utilize ultrasound in breast reconstruction to evaluate implants, seroma, hematoma, and fat grafting sites in the clinic and postoperative setting.
5. Integrate ultrasound into postoperative monitoring algorithms to differentiate normal findings from complications and reduce unnecessary imaging or re-exploration

A growing population of patients presents with dysvascular limbs deemed "no-option" for conventional endovascular or open bypass revascularization, with major amputation as the historical endpoint. Distraction angiogenesis and venous arterialization are two emerging strategies expanding the reconstructive algorithm and offering durable salvage where traditional approaches have failed.

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

1. Define distraction angiogenesis and venous arterialization and explain their mechanistic rationale in limb salvage for "no-option" dysvascular patients.
2. Identify appropriate patient selection criteria and imaging workup for considering distraction angiogenesis or venous arterialization in dysvascular limbs.
3. Outline stepwise surgical techniques for performing distraction angiogenesis and venous arterialization, including key technical pitfalls and strategies to avoid failure.
4. Compare expected outcomes, complication profiles, and durability of these emerging strategies relative to traditional bypass, endovascular options, and major amputation.
5. Develop an algorithm for incorporating distraction angiogenesis and venous arterialization into a multidisciplinary limb salvage program.

Augmented intelligence will play a defining role in the next era of reconstructive microsurgery, reshaping how we select patients, plan operations, and design practices. This instructional course positions augmented intelligence not as a research novelty, but as core infrastructure for the future microsurgical ecosystem.

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

1. Describe core concepts in augmented intelligence, including predictive modeling and decision-support tools, and how they apply to reconstructive microsurgery.
2. Interpret and critically appraise risk prediction and patient-reported outcome models to inform patient selection, counseling, and shared decision-making.
3. Identify perioperative use cases for augmented intelligence, such as pathway optimization, resource forecasting, and intraoperative or postoperative decision support.
4. Discuss how operational and business analytics can be used to plan capacity, improve throughput, and optimize financial performance in microsurgical practices.
5. Outline practical steps, including data, governance, and ethical considerations, for implementing augmented intelligence tools within academic and private practice environments.

"What Keeps You Up at Night: Grafting Challenges Across Reconstructive Microsurgery, Hand Surgery, and Peripheral Nerve Surgery" brings together expert panelists from ASRM/AAHS/ASPN to confront the cases, complications, and clinical dilemmas that haunt even the most experienced reconstructive surgeons. From arterial and venous grafting in the setting of zone-of-injury trauma, to nerve grafting across long gaps with uncertain recovery, to vascularized bone grafting in complex skeletal defects, the challenges that cross subspecialty boundaries are often the ones with no clean answers. This panel leverages the complementary expertise of three distinct surgical communities to examine shared problems through different lenses — fostering the kind of cross-disciplinary dialogue that is increasingly essential as reconstructive surgery pushes into ever more complex territory. Through case-based discussion and candid exchange, panelists will explore the decision-making processes, technical pitfalls, and hard-won lessons that define the frontier of grafting in reconstruction.

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

1. Identify the key technical and biological factors that influence graft selection — arterial, venous, nerve, or bone — in complex reconstructive scenarios, and articulate how decision-making differs across microsurgical, hand, and peripheral nerve surgical contexts.
2. Analyze challenging grafting cases through a multidisciplinary lens, recognizing how the perspectives of reconstructive microsurgeons, hand surgeons, and peripheral nerve surgeons can complement and inform one another in the management of difficult clinical problems.
3. Apply practical strategies for anticipating and managing the complications, failures, and ethical dilemmas most commonly encountered in grafting procedures, including discussions of when to proceed, when to stage, and when to consider alternative reconstructive approaches.