Disorders of the Wrist


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Disorders of the Wrist

  1. 1. Mayo School of Continuous Professional DevelopmentDISORDERSOF THE WRISTMay 24-26, 2013Heritage Hall, Kahler Grand HotelRochester, Minnesota Pre-Conference Laboratory Workshop ANATOMY OF THE WRIST May 23, 2013 REGISTER ONLINE NOW! www.mayo.edu/cme
  2. 2. GENERAL INFORMATIONCOURSE DESCRIPTIONDisorders of the Wrist is designed for orthopedic and plastic surgeons with asignificant hand practice and covers the spectrum of disorders of the wrist anddistal radioulnar joint. The format will be case-oriented, covering topics in bonyand soft tissue trauma, degenerative disease, and inflammatory arthritis, to namea few. Videotaped surgery clips and cadaveric surgical dissection will be used todemonstrate complicated surgical procedures.The course will begin with a review of normal wrist anatomy and mechanics,including examination maneuvers, imaging modalities and surgical exposures.The pertinent features of each wrist disorder will then be highlighted, followedby detailed descriptions of treatment techniques and outcomes. Case exampleswill be presented prior to each didactic session, followed by open discussion.Breakout sessions will provide more in-depth coverage of specific wrist topicsand provide updates on advances in arthroscopy and arthroplasty fromrecognized experts in the field. A strong emphasis will be placed on surgicaltechnique. Registrants are encouraged to bring their own cases to discuss withthe faculty. Special times for these exchanges will be arranged.COURSE LEARNING OBJECTIVESUpon conclusion of this program, participants should be able to:• Evaluate the latest advancements both surgical and non-surgical for the treatment of thumb arthritis.• Construct a diagnostic and treatment algorithm for the treatment of scapholunate and perilunate injuries.• Construct a diagnostic and treatment algorithm for ulnar sided wrist pain and DRUJ instability.Attendance at this Mayo course does not indicate nor guarantee competence orproficiency in the performance of any procedures which may be discussed ortaught in this course.CREDITCollege of Medicine, Mayo Clinic, is accredited by the Accreditation Councilfor Continuing Medical Education to provide continuing medical education forphysicians.College of Medicine, Mayo Clinic, designates this live activity for a maximumof 28.25 AMA PRA Category 1 Credits™. Physicians should claim only the creditcommensurate with the extent of their participation in the activity.GRANTS AND EXHIBITSAt the time of this printing, a complete listing of commercial supporters was notavailable. Appropriate acknowledgment will be given to all supporters at thetime of the meeting.Exhibits will be available for viewing at all scheduled breaks.
  3. 3. GENERAL INFORMATIONDATE AND LOCATIONDisorders of the Wrist will be held May 24-26, 2013, with the Pre-ConferenceLaboratory Workshop preceding the course on Thursday, May 23, 2013. ThePre-Conference Laboratory Workshop will take place in Mayo Clinic’s state-of-the-art Surgical Skills Laboratory, located in the Stabile Medical ScienceBuilding. Beginning on Friday, May 24, 2013, course headquarters will be locatedin Heritage Hall, in the subway level of the Kahler Grand Hotel in Rochester,Minnesota. Meeting facilities are easily accessible by skyway and pedestriansubway, which connect Mayo Clinic to shops, restaurants, and hotels.REGISTRATIONTo register online, visit www.mayo.edu/cme/orthopedic-surgery-2013r852, orcomplete the attached registration form and return by mail or fax. Theregistration fee includes tuition, comprehensive electronic course syllabus,continental breakfasts, break refreshments, and reception. Although it is notMayo School of Continuous Professional Development (CPD) policy to limit thenumber of registrants for a course, conference room facilities may necessitateclosing of enrollment; therefore, early registration is advised. A letter ofconfirmation will be sent upon receipt of payment and completed registrationform. Please present the confirmation letter when checking in at the meetingregistration desk.For additional information, contact: Website: www.mayo.edu/cmeMayo School of Continuous E-mail: cme@mayo.eduProfessional Development Phone: 800-323-2688 or 507-284-2509Plummer 2-60 Fax: 507-284-0532200 First Street SWRochester, MN 55905CANCELLATION POLICYIf you cancel your participation in this course, your registration fee, less a $75administrative fee, will be refunded when written notification is received byMayo School of CPD before May 9, 2013 (cme@mayo.edu or fax#: 507-284-0532).No refunds will be made on or after May 9, 2013. Canceled registrations arenon-transferable.Mayo School of CPD reserves the right to cancel or postpone any course dueto unforeseen circumstances. In the unlikely event Mayo School of CPD mustcancel or postpone this course, Mayo School of CPD will refund the registrationfee, but is not responsible for any related costs, charges, or expenses toparticipants, including fees assessed by airline/travel/lodging agencies.TRAVELRochester, Minnesota, is a friendly city that greets thousands of visitors fromaround the world each year. The city is serviced by a modern internationalairport with multiple flights daily via American or Delta Airlines. Access to andfrom the airport is provided by taxi, shuttle service, and rental car. The airport islocated approximately 10 miles from the Mayo Clinic campus.
  4. 4. GENERAL INFORMATIONMayo Clinic’s appointed travel company, Ultramar Travel, is available to assistwith your travel arrangements. To make your reservation, phone UltramarTravel toll-free at 1-866-629-6885. Note to Travelers: Several cities in the United States are named Rochester. Whenyou make airline reservations and check your baggage, be sure that yourdestination is Rochester, Minnesota (RST) and that your baggage has beenproperly tagged.Travel arrangements are the sole responsibility of the individual registrant.PARKINGParking is available in hotel, city, and Mayo patient/visitor ramps. The cost forparking is not included in the registration fee. A map indicating the location ofdowntown parking facilities will be mailed with the registrant confirmation letter.LODGING ACCOMMODATIONSGuest rooms have been reserved for attendees and their guests with specialcourse rates at each of the following downtown Rochester hotels. In order toreceive the special rate, reservations must be made before the room block is filledor before the expiration date of May 1, 2013, whichever comes first. Reservationswill be taken following this date based on space and rate availability. Pleaseidentify yourself as a participant of the Disorders of the Wrist when making yourreservation.Kahler Grand Hotel20 Second Avenue SW800-533-1655 or 507-282-2581$102/$129 deluxe king/executive king Rochester Marriott Hotel101 First Avenue SW877-623-7775 or 507-280-6000$143 single/double DoubleTree Hotel150 South Broadway507-281-8000 $129 single/doubleThe hotels listed above are connected by skyway and pedestrian subway toconference facilities, downtown shops, and restaurants. You may wish to visitthe Rochester Convention and Visitors Bureau website (www.rochestercvb.org)and/or www.rochester411.com for additional accommodation options and areainformation.Lodging arrangements are the sole responsibility of the individual registrant.Mayo School of CPD is not responsible for expenses incurred by an individualwho is not confirmed and for whom space is not available at the meeting.Costs incurred by the registrant such as airline or hotel fees or penalties are theresponsibility of the registrant.
  5. 5. GENERAL INFORMATIONFACULTYCourse Directors Guest FacultyRichard A. Berger, M.D., Ph.D.Professor of Orthopedics Brian D. Adams, M.D., Ph.D.Department of Orthopedic Surgery University of Iowa Orthopedic SurgeryMayo Clinic Iowa City, IowaSteven L. Moran, M.D. Gregory I. Bain, Ph.D., FRCSProfessor and Chair Plastic Surgery Modbury Medical CentreProfessor of Orthopedic Surgery North Adelaide, South AustraliaMayo Clinic Martin I. Boyer, M.D., FRCSMayo Faculty Washington University School of MedicinePeter C. Amadio, M.D. St. Louis, MissouriKimberly K. Amrami, M.D.Allen T. Bishop, M.D. Marc Garcia-Elias, M.D., Ph.D.Brian T. Carlsen, M.D. Institut KaplanWilliam P. Cooney, III, M.D. Barcelona, SpainDavid G. Dennison, M.D.Bassem T. El Hassan, M.D. Michael Hayton, FRCS(TrOrth)Sanjeev Kakar, M.D. Wrightington HospitalPeter M. Murray, M.D. Lancashire, United KingdomJose A. Ortiz, M.D.Marco Rizzo, M.D. Guillaume Herzberg, M.D., Ph.D.Alexander Y. Shin, M.D. Edouard Herriot HospitalScott P. Steinmann, M.D. Lyon, France P.C. Ho, MBBS, FRCS Prince of Wales Hospital Shatin, N.T., Hong Kong Kurt Pettersson, M.D. Orebro University Hospital Orebro, Sweden David J. Slutsky, M.D. Hand & Wrist Institute Torrence, California Michael Strassmair, M.D. Zentrum fur Handchirurgie Starnberg, Germany Robert M. Szabo, M.D, MPH University of California-Davis Sacramento, California Ian A. Trail, M.D., FRCS Wrightington Hospital Lancashire, United Kingdom
  6. 6. PROGRAM SCHEDULEThursday, Mayo 23, 2013Pre-Conference Laboratory Workshop – Anatomy of the Wrist6:30 a.m. Registration and Breakfast Heritage Hall, Subway Level, Kahler Grand Hotel7:30 a.m. Welcome and Introduction (Move to Stabile, 9th Floor) Richard A. Berger, M.D., Ph.D.8:00 a.m. Lecture: Anatomy of the Wrist Richard A. Berger, M.D., Ph.D.9:00 a.m. Lecture: Surgical Approaches to the Wrist Richard A. Berger, M.D., Ph.D.9:30 a.m. Refreshment Break9:45 a.m. Dissection: Dorsal Surgical Exposures & Dorsal Wrist Anatomy Faculty & Laboratory Staff12:00 p.m. Lunch Heritage Hall, Subway Level, Kahler Grand Hotel1:00 p.m. Dissection: Palmar Surgical Exposures, Palmar Wrist Anatomy, & Anatomy of the DRUJ Faculty & Laboratory Staff2:30 p.m. Refreshment Break2:40 p.m. Surgical Procedures: Modified Brunelli and DRUJ Reconstruction Richard A. Berger, M.D., Ph.D. & Steven L. Moran, M.D.3:30 p.m. Surgical Procedures: Pedicled Vascularized Bone Grafts, TWA Steven L. Moran, M.D. and Brian D. Adams, M.D., Ph.D.4:00 p.m. Adjourn Friday, May 24, 2013General Session – Disorders of the Wrist6:30 a.m. Breakfast Heritage Hall, Subway Level, Kahler Grand Hotel7:30 a.m. Welcome and Course Overview Richard A. Berger, M.D., Ph.D.Session I: The Painful Wrist – Where Do I Start?Moderator: Steven L. Moran, M.D.7:30 a.m. Introduction and Case Presentation Steven L. Moran, M.D.7:35 a.m. Examination of the Wrist Richard A. Berger, M.D., Ph.D.7:50 a.m. Radiology in the Diagnosis of Radial Sided Wrist Pain. The Validity of MRI and MR Arthrography Kimberly K. Amrami, M.D.8:05 a.m. Arthroscopy: Anatomy and Pearls for Diagnostic Accuracy David J. Slutsky, M.D.8:20 a.m. Case Wrap Up and Audience Vote on Treatment Steven L. Moran, M.D.Session II: Soft Tissue Trauma – Scapholunate DissociationModerator: Peter C. Amadio, M.D.8:30 a.m. Case Presentation, Overview, Classification, Natural History Peter C. Amadio, M.D.8:35 a.m. Scapholunate Injury: Kinematics and Classification Marc Garcia-Elias, M.D., Ph.D.
  7. 7. PROGRAM SCHEDULE9:00 a.m. Closed and Arthroscopic Options (Pinning, Shrinkage) - When Will It Work? Grade 2 and 3 Instability David J. Slutsky, M.D.9:15 a.m. Dynamic Instability and the Role of Capsulodesis Robert M. Szabo, M.D., MPH9:35 a.m. Tenodesis Ian A. Trail, M.D., FRCS9:50 a.m. Tenodesis, Suture Augmentation, and Intra-Articular Screws Gregory I. Bain, Ph.D., FRCS10:05 a.m. Case Discussion & Review of Audience Response Peter C. Amadio, M.D.10:15 a.m. Refreshment BreakSession IIIA: Acute Scaphoid FractureModerator: Alexander Y. Shin, M.D.10:30 a.m. Case Presentation, Overview, Classification Alexander Y. Shin, M.D.10:45 p.m. Radiographic Assessment, MRI, CT, Bone Scan Kimberly K. Amrami, M.D.11:00 a.m. Casting Versus Screw: When and Who David G. Dennison, M.D.11:15 a.m. Surgical Demonstration: Arthroscopic Reduction and Screw Fixation David J. Slutsky, M.D.11:30 a.m. Proximal Pole Fractures: Avoiding Non-Union Alexander Y. Shin, M.D.11:45 a.m. Scaphoid Fractures in the Athlete: When to Fix and When to Move Michael Hayton, M.D., FRCS12:00 p.m. Case Discussion: Audience Response Alexander Y. Shin, M.D.12:15 p.m. LunchSession IIIB: Scaphoid NonunionModerator: Alexander Y. Shin, M.D.1:15 p.m. Case Presentation, Overview, Classification, Natural History Alexander Y. Shin, M.D.1:30 p.m. Management Without Grafting Jose A. Ortiz, M.D.1:45 p.m. Volar Grafting Techniques: Russe and Do You Really Need A Vascular Pedicle Michael Hayton, M.D., FRCS2:00 p.m. Russe versus Wedge Graft William P. Cooney, III, M.D.2:15 p.m. Overview and Surgical Demonstration: Dorsally and Volar Based Vascularized Bone Grafts Allen T. Bishop, M.D.2:30 p.m. The Medial Femoral Condyle Alexander Y. Shin, M.D., FRCS2:40 p.m. Articular Grafts Free and Vascularized Steven L. Moran, M.D.2:50 p.m. Case Wrap-Up and Review of Audience Response Alexander Y. Shin, M.D.3:00 p.m. Refreshment Break
  8. 8. PROGRAM SCHEDULESession IV: Perilunate and LT InjuryModerator: Peter M. Murray, M.D.3:20 p.m. Overview and Case Presentation Peter M. Murray, M.D.3:35 p.m. Greater Arc Variants Gregory I. Bain, Ph.D., FRCS3:50 p.m. Management and long-term outcomes Guillaume Herzberg, M.D., Ph.D.4:05 p.m. LT Instability Allen T. Bishop, M.D.4:20 p.m. Axial Carpal Injuries David G. Dennison, M.D.4:35 p.m. Pisotriquetral Problems Michael Hayton, M.D., FRCS4:50 p.m. Case Discussion Peter M. Murray, M.D.5:00 p.m. Refreshment BreakBreakout Sessions I5:15 p.m. Kienbock’s Disease: My Treatment Algorithm Gregory I. Bain, Ph.D., FRCS, Allen T. Bishop, M.D., William P. Cooney, III, M.D., and Robert M. Szabo, M.D., MPH5:15 p.m. The Rheumatoid Wrist Guillaume Herzberg, M.D., Ph.D., Kurt Pettersson, M.D., Marco Rizzo, M.D., and Ian A. Trail, M.D.6:30 p.m. AdjournSaturday May 25, 20136:30 a.m. Breakfast Heritage Hall, Subway Level, Kahler Grand HotelSession V: Wrist ArthritisModerator: David J. Slutsky, M.D.7:30 a.m. Wrist Salvage-Overview, Case Presentation: SLAC SNAC and Radiocarpal Arthrosis David J. Slutsky, M.D.7:45 a.m. 4-Corner David G. Dennison, M.D.8:00 a.m. PRC Steven L. Moran, M.D.8:15 a.m. Radiolunate Fusion Guillaume Herzberg, M.D., Ph.D.8:30 a.m. Radioscapholunate Fusion Marc Garcia-Elias, M.D., Ph.D.8:45 a.m. Arthroscopic Management of Arthritis P.C. Ho, MBBS, FRCS9:00 a.m. Bone Shape and Carpal Mechanics: Distal Pole Resection Steven L. Moran, M.D.9:15 a.m. Wrist Replacement Guillaume Herzberg, M.D., Ph.D.9:30 a.m. Wrist Replacement: Long Term Outcomes Kurt Pettersson, M.D.9:45 a.m. Wrist Replacement and Hemi Wrist Arthroplasty Brian D. Adams, M.D., Ph.D.
  9. 9. PROGRAM SCHEDULE10:00 a.m. Neurectomy Richard A. Berger, M.D., Ph.D.10:10 a.m. Case Discussions and Questions David J. Slutsky, M.D.10:15 a.m. Refreshment BreakSession V: Ulnar-Sided Wrist Pain. Where Do I Start?Moderator: Martin I. Boyer, M.D., Ph.D.10:30 a.m. Case Presentation and Examination of the Wrist Martin I. Boyer, M.D., Ph.D.10:45 a.m. Radiology in Diagnosis of Ulnar Wrist Pain. The Validity of MRI and Can You See the UT Ligament Kimberly K. Amrami, M.D.11:00 a.m. Pathoanatomy and Kinematics of TFCC and DRUJ Brian D. Adams, M.D., Ph.D.11:20 a.m. Diagnostic Arthroscopy: Midcarpal Instability P.C. Ho, MBBS, FRCS11:35 a.m. Surgical Approach to the Ulnar Aspect of the Wrist Marc Garcia-Elias, M.D., Ph.D.11:50 a.m. Case Discussion Martin I. Boyer, MD, Ph.D.12:00 p.m. LunchSession VII: TFCC InjuryModerator: Bassem T. El Hassan, M.D.1:00 p.m. Overview and Anatomy Marc Garcia-Elias, M.D., Ph.D.1:10 p.m. TFCC Injuries, My Repair Technique Bassem T. El Hassan, M.D.1:25 p.m. Arthroscopic Management of TFCC Tears, Wide Awake Surgery P.C. Ho, MBBS, FRCS1:40 p.m. UT Split Tears Richard A. Berger, M.D., Ph.D.1:55 p.m. Impaction Marco Rizzo, M.D.2:25 p.m. Failures and Recurrent TFCC Tears Brian D. Adams, M.D., Ph.D.2:40 p.m. Case Discussion Bassem T. El Hassan, M.D.2:55 p.m. Refreshment BreakSession VIII: DRUJ Injuries and DRUJ SalvageModerator: Martin I. Boyer, M.D., Ph.D.3:15 p.m. Case Presentation, Overview, Natural History Martin I. Boyer, M.D., Ph.D.3:30 p.m. Acute Dislocations and Galeazzi fractures Brian T. Carlsen, M.D.3:45 p.m. Chronic Instability Brian D. Adams, M.D., Ph.D.4:00 p.m. Herbert Distal Ulnar Head Replacement Ian A. Trail, M.D., FRCS4:15 p.m. Hemi Endoprosthesis Steven L. Moran, M.D.4:30 p.m. Total Ulnar Head Prosthesis Richard A. Berger, M.D., Ph.D.
  10. 10. PROGRAM SCHEDULE4:45 p.m. Salvage of Failed DRUJ Reconstruction: Darrach and the One Bone Forearm Ian A. Trail, M.D., FRCS5:00 p.m. It’s Not the Wrist; It’s the Elbow Scott P. Steinmann, M.D.5:15 p.m. Madlung’s Deformity Michael Strassmair, M.D.5:30 p.m. Pediatric DRUJ Steven L. Moran, M.D.5:45 p.m. Case Discussion Martin I. Boyer, M.D., Ph.D.6:00 p.m. Conference Reception & ExhibitsSunday, May 26, 20137:00 a.m. Breakfast Heritage Hall, Subway Level, Kahler Grand HotelOsseous Trauma: Distal Radius FractureModerator: Martin I. Boyer, M.D., Ph.D.7:30 a.m. Case Presentation, Overview, Classification Martin I. Boyer, M.D., Ph.D.7:45 a.m. Distal Radius Anatomy Gregory I. Bain, Ph.D., FRCS8:00 a.m. Volar Plates David G. Dennison, M.D.8:15 a.m. Fragment Specific Fixation Alexander Y. Shin, M.D.8:30 a.m. Dorsal Plating-Is There Still a Role? Kurt Pettersson, M.D.8:45 a.m. Distal radius fracture:An evidence based approach Robert M. Szabo, M.D., MPH9:00 a.m. Intramedullary Cage Michael Strassmair, M.D.9:15 a.m. Bridge Plate Bassem T. El Hassan, M.D.9:30 a.m. Arthroscopic Management of Pain Following DR Fractures P.C. Ho, MBBS, FRCS9:45 a.m. Refreshment Break10:15 a.m. Bone Grafting: When and With What Sanjeev Kakar, M.D.10:45 a.m. Arthrodesis: The Ultimate Salvage Marco Rizzo, M.D.11:00 a.m. Malunions David G. Dennison, M.D.11:15 a.m. Case Discussion and Questions Martin I. Boyer, M.D., Ph.D.11:30 a.m. Panel Discussion: Managing Difficult and Recurrent CMC Arthritis Marco Rizzo, M.D., Peter C. Amadio, M.D., Kurt Pettersson, M.D., and Sanjeev Kakar, M.D.12:30 p.m. Adjourn
  11. 11. REGISTRATION FORM 2013R852Disorders of the WristMay 24-26, 2013Heritage Hall, Kahler Grand Hotel • Rochester, MinnesotaMail form and payment to:Mayo School of CPD Phone 800-323-2688 or 507-284-2509Plummer 2-60 FAX 507-284-0532200 First Street SW E-mail cme@mayo.edu­Rochester, MN 55905 Web site www.mayo.edu/cme Register online at: http://www.mayo.edu/cme/orthopedic-surgery-2013r852Contact InformationName of Registrant – first name, middle name or initial, and last name Degree – select all that apply MD PhD DO PA NP Other - specifyName of Institution Medical SpecialtyPreferred Mailing Address – select one Work/Business HomeWork/Business Address – street address Work Phone – include all country and city/area codes as needed along with complete phone numberCity State or Province ZIP or Postal Code CountryHome Address – street address Home Phone – include all country and city/area codes as needed along with complete phone numberCity State or Province ZIP or Postal Code CountryE-mail Address (Note: email is the Mayo School of FAX – include all country and city/area codes as FAX Location – select oneCME’s primary form of correspondence.) needed along with complete phone number Work/Business Home If you have special assistance needs or dietary restrictions, describe here: SPECIAL NEEDSRegistrationPlease indicate if you will be attending the following: Pre-Conference Laboratory Workshop – Anatomy of the Wrist (May 23, 2013) General Session – Disorders of the Wrist (May 24-26, 2013)Registration Fee: Physicians/Scientists – $1,000 $_______ Residents, Physician Assistants and Nurse Practitioners – $850 $ _______ Pre-Conference Laboratory Workshop – $500 $ _______Total Payment Enclosed $ _______Payment Information * (US funds only. Wire transfers will be assessed a $25 USD fee.) Check is enclosed in the amount shown at right – make checks payable to Mayo Clinic Payment Total Credit Card – select one Discover MasterCard Visa Account Number Exp Date – mm/yy Name of Cardholder – as it appears on the card Signature of Cardholder – required X
  12. 12. MAYO CLINIC200 First Street SWRochester, MN 55905Mayo School of Continuous Professional DevelopmentDISORDERSOF THE WRISTMay 24-26, 2013Heritage HallKahler Grand Hotel • Rochester, MinnesotaPre-Conference Laboratory WorkshopANATOMY OF THE WRISTMay 23, 2013If you already received a copy of this brochure, please give REGISTER TODAY!to an interested colleague.© 2012 Mayo Foundation for Medical Education and ResearchMC8020-78