Disorders of the Wrist

DISORDERS OF THE WRIST

Mayo School of Continuous Professional Development

REGISTER ONLINE NOW!www.mayo.edu/cme

May 24-26, 2013

Heritage Hall, Kahler Grand HotelRochester, Minnesota

Pre-Conference Laboratory WorkshopANATOMY OF THE WRISTMay 23, 2013

GENERAL INFORMATION

COURSE DESCRIPTION

Disorders of the Wrist is designed for orthopedic and plastic surgeons with a significant hand practice and covers the spectrum of disorders of the wrist and distal radioulnar joint. The format will be case-oriented, covering topics in bony and soft tissue trauma, degenerative disease, and inflammatory arthritis, to name a few. Videotaped surgery clips and cadaveric surgical dissection will be used to demonstrate 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, followed by detailed descriptions of treatment techniques and outcomes. Case examples will be presented prior to each didactic session, followed by open discussion. Breakout sessions will provide more in-depth coverage of specific wrist topics and provide updates on advances in arthroscopy and arthroplasty from recognized experts in the field. A strong emphasis will be placed on surgical technique. Registrants are encouraged to bring their own cases to discuss with the faculty. Special times for these exchanges will be arranged.

COURSE LEARNING OBJECTIVES

Upon conclusion of this program, participants should be able to:

• Evaluatethelatestadvancementsbothsurgicalandnon-surgicalforthetreatment of thumb arthritis.

• Constructadiagnosticandtreatmentalgorithmforthetreatmentofscapholunate and perilunate injuries.

• ConstructadiagnosticandtreatmentalgorithmforulnarsidedwristpainandDRUJ instability.

Attendance at this Mayo course does not indicate nor guarantee competence or proficiency in the performance of any procedures which may be discussed or taught in this course.

CREDIT

College of Medicine, Mayo Clinic, is accredited by the Accreditation Council forContinuingMedicalEducationtoprovidecontinuingmedicaleducationforphysicians.

College of Medicine, Mayo Clinic, designates this live activity for a maximum of 28.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

GRANTS AND EXHIBITS

At the time of this printing, a complete listing of commercial supporters was not available. Appropriate acknowledgment will be given to all supporters at the time of the meeting.

Exhibitswillbeavailableforviewingatallscheduledbreaks.

GENERAL INFORMATION

DATE AND LOCATION

Disorders of the Wrist will be held May 24-26, 2013, with the Pre-Conference Laboratory Workshop preceding the course on Thursday, May 23, 2013. The Pre-Conference Laboratory Workshop will take place in Mayo Clinic’s state-of-the-art Surgical Skills Laboratory, located in the Stabile Medical Science Building. Beginning on Friday, May 24, 2013, course headquarters will be located in Heritage Hall, in the subway level of the Kahler Grand Hotel in Rochester, Minnesota. Meeting facilities are easily accessible by skyway and pedestrian subway, which connect Mayo Clinic to shops, restaurants, and hotels.

REGISTRATION

To register online, visit www.mayo.edu/cme/orthopedic-surgery-2013r852, or complete the attached registration form and return by mail or fax. The registration fee includes tuition, comprehensive electronic course syllabus, continental breakfasts, break refreshments, and reception. Although it is not Mayo School of Continuous Professional Development (CPD) policy to limit the number of registrants for a course, conference room facilities may necessitate closing of enrollment; therefore, early registration is advised. A letter of confirmation will be sent upon receipt of payment and completed registration form. Please present the confirmation letter when checking in at the meeting registration desk.

For additional information, contact: Website: www.mayo.edu/cmeMayo School of Continuous E-mail: [email protected] Development Phone: 800-323-2688 or 507-284-2509Plummer 2-60 Fax: 507-284-0532200 First Street SWRochester, MN 55905

CANCELLATION POLICY

If you cancel your participation in this course, your registration fee, less a $75 administrative fee, will be refunded when written notification is received by Mayo School of CPD before May 9, 2013 ([email protected] or fax#: 507-284-0532). No refunds will be made on or after May 9, 2013. Canceled registrations are non-transferable.

Mayo School of CPD reserves the right to cancel or postpone any course due to unforeseen circumstances. In the unlikely event Mayo School of CPD must cancel or postpone this course, Mayo School of CPD will refund the registration fee, but is not responsible for any related costs, charges, or expenses to participants, including fees assessed by airline/travel/lodging agencies.

TRAVEL

Rochester, Minnesota, is a friendly city that greets thousands of visitors from around the world each year. The city is serviced by a modern international airport with multiple flights daily via American or Delta Airlines. Access to and from the airport is provided by taxi, shuttle service, and rental car. The airport is located approximately 10 miles from the Mayo Clinic campus.

GENERAL INFORMATION

Mayo Clinic’s appointed travel company, Ultramar Travel, is available to assist with your travel arrangements. To make your reservation, phone Ultramar Travel toll-free at 1-866-629-6885. Note to Travelers: Several cities in the United States are named Rochester. When you make airline reservations and check your baggage, be sure that your destination is Rochester, Minnesota (RST) and that your baggage has been properly tagged.

Travel arrangements are the sole responsibility of the individual registrant.

PARKING

Parking is available in hotel, city, and Mayo patient/visitor ramps. The cost for parking is not included in the registration fee. A map indicating the location of downtown parking facilities will be mailed with the registrant confirmation letter.

LODGING ACCOMMODATIONS

Guest rooms have been reserved for attendees and their guests with special course rates at each of the following downtown Rochester hotels. In order to receive the special rate, reservations must be made before the room block is filled or before the expiration date of May 1, 2013, whichever comes first. Reservations will be taken following this date based on space and rate availability. Please identify yourself as a participant of the Disorders of the Wrist when making your reservation.

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 Hotel 150 South Broadway507-281-8000 $129 single/double

The hotels listed above are connected by skyway and pedestrian subway to conference facilities, downtown shops, and restaurants. You may wish to visit the Rochester Convention and Visitors Bureau website (www.rochestercvb.org) and/or www.rochester411.com for additional accommodation options and area information.

Lodging arrangements are the sole responsibility of the individual registrant.

Mayo School of CPD is not responsible for expenses incurred by an individual who 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 the responsibility of the registrant.

GENERAL INFORMATION

FACULTY

Course DirectorsRichard A. Berger, M.D., Ph.D.Professor of OrthopedicsDepartment of Orthopedic SurgeryMayo Clinic

Steven L. Moran, M.D.Professor and Chair Plastic SurgeryProfessor of Orthopedic SurgeryMayo Clinic

Mayo Faculty

Peter C. Amadio, M.D.Kimberly K. Amrami, M.D.Allen T. Bishop, M.D.Brian T. Carlsen, M.D.William P. Cooney, III, M.D.David G. Dennison, M.D.Bassem T. El Hassan, M.D.Sanjeev Kakar, M.D.Peter M. Murray, M.D.Jose A. Ortiz, M.D.Marco Rizzo, M.D.Alexander Y. Shin, M.D.Scott P. Steinmann, M.D.

Guest Faculty

Brian D. Adams, M.D., Ph.D.University of Iowa Orthopedic SurgeryIowa City, Iowa

Gregory I. Bain, Ph.D., FRCSModbury Medical CentreNorth Adelaide, South Australia

Martin I. Boyer, M.D., FRCSWashington University School of MedicineSt. Louis, Missouri

Marc Garcia-Elias, M.D., Ph.D.Institut KaplanBarcelona, Spain

Michael Hayton, FRCS(TrOrth)Wrightington HospitalLancashire, United Kingdom

Guillaume Herzberg, M.D., Ph.D.EdouardHerriotHospitalLyon, France

P.C. Ho, MBBS, FRCSPrince of Wales HospitalShatin, N.T., Hong Kong

Kurt Pettersson, M.D.Orebro University HospitalOrebro, Sweden

David J. Slutsky, M.D.Hand & Wrist InstituteTorrence, California

Michael Strassmair, M.D.Zentrum fur HandchirurgieStarnberg, Germany

Robert M. Szabo, M.D, MPHUniversity of California-DavisSacramento, California

Ian A. Trail, M.D., FRCSWrightington HospitalLancashire, United Kingdom

PROGRAM SCHEDULE

Thursday, Mayo 23, 2013Pre-Conference Laboratory Workshop – Anatomy of the Wrist

6:30 a.m. Registration and Breakfast Heritage Hall, Subway Level, Kahler Grand Hotel

7:30 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 Break

9:45a.m. Dissection:DorsalSurgicalExposures&DorsalWristAnatomy Faculty & Laboratory Staff

12:00 p.m. Lunch Heritage Hall, Subway Level, Kahler Grand Hotel

1:00p.m. Dissection:PalmarSurgicalExposures,PalmarWristAnatomy,&Anatomy of the DRUJ

Faculty & Laboratory Staff

2:30 p.m. Refreshment Break

2:40 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 Wrist

6:30 a.m. Breakfast Heritage Hall, Subway Level, Kahler Grand Hotel

7:30 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.

7:35a.m. ExaminationoftheWrist 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.

PROGRAM SCHEDULE

9:00 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., MPH

9:35 a.m. Tenodesis Ian A. Trail, M.D., FRCS

9:50 a.m. Tenodesis, Suture Augmentation, and Intra-Articular Screws Gregory I. Bain, Ph.D., FRCS

10:05 a.m. Case Discussion & Review of Audience Response Peter C. Amadio, M.D.


Session 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., FRCS

12:00 p.m. Case Discussion: Audience Response Alexander Y. Shin, M.D.

12:15 p.m. Lunch

Session 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., FRCS

2:00 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., FRCS

2:40 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.


PROGRAM SCHEDULE

Session 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., FRCS

3:50 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., FRCS

4:50 p.m. Case Discussion Peter M. Murray, M.D.


Breakout Sessions I

5:15 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., MPH

5:15 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. Adjourn

Saturday May 25, 2013


Session 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, FRCS

9:00 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.

PROGRAM SCHEDULE

10:00 a.m. Neurectomy Richard A. Berger, M.D., Ph.D.

10:10 a.m. Case Discussions and Questions David J. Slutsky, M.D.


Session V: Ulnar-Sided Wrist Pain. Where Do I Start?Moderator: Martin I. Boyer, M.D., Ph.D.

10:30a.m. CasePresentationandExaminationoftheWrist 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, FRCS

11:35 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. Lunch

Session 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, FRCS

1:40 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.


Session 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., FRCS

4:15p.m. HemiEndoprosthesis Steven L. Moran, M.D.

4:30 p.m. Total Ulnar Head Prosthesis Richard A. Berger, M.D., Ph.D.

PROGRAM SCHEDULE

4:45 p.m. Salvage of Failed DRUJ Reconstruction: Darrach and the One Bone Forearm Ian A. Trail, M.D., FRCS

5:00p.m. It’sNottheWrist;It’stheElbow 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.

6:00p.m. ConferenceReception&Exhibits

Sunday, May 26, 2013


Osseous 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., FRCS

8:00 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., MPH

9:00 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, FRCS


10:15 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

Disorders of the WristMay 24-26, 2013Heritage Hall, Kahler Grand Hotel • Rochester, Minnesota

REGISTRATION FORM 2013R852

Mail 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 [email protected] Rochester, MN 55905 Web site www.mayo.edu/cme

Register online at: http://www.mayo.edu/cme/orthopedic-surgery-2013r852

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Disorders of the Wrist