Central Deficiency (cleft hand) Radial Deficiency Travels and Meetings

Hand Society 2013

Last week was the annual meeting of the American Society for Surgery of the Hand in San Francisco.  As usual, it was a great meeting with an amazing collection of speakers giving paper presentations and courses on a variety of topics.  There were two presentations of congenital research from our institution (along with a number of other presentations from our institution) and both were fantastic.

Claire Manske (an orthopaedic resident) presented the results  (at 6+ years) of children treated with fixator distraction prior to centralization for radial deficiency.  Results were good but recurrence of the radial angulation was more notable than expected.  This is something we will continue to monitor moving forward as we feel the technique of using the fixator is still valuable (maintains wrist motion and makes centralization procedure easier).  We are in the process of publishing these results.

Alex Aleem (also an orthopaedic resident) presented on cleft hand treatment, specifically the results of patients treated with a transverse bone (i.e., a bone lying 90 degrees to the expected position).

Cleft hand with transverse bone.

Again, Alex did a wonderful job and the paper is in the process of being published.  The results were overall very good.

Additionally, I was able to participate in a couple of sessions specifically on children.  First, Michael Tonkin from Sydney Australia and I led a precourse (4 hours course prior to official start of meeting) with 150+ attendees and a wonderful faculty discussing cerebral palsy, brachial plexus, and arthrogryposis as well as other birth anomalies of the upper extremity.  Great course.
I also presented at 2 other courses on kids- the first on the complications of common pediatric and congenital procedures.  Complications are fortunately uncommon in procedures on children (whether trauma cases or birth anomaly cases or other types of cases) but are extremely educational.  Sharing such experiences helps everyone learn and, hopefully, avoid complications (when avoidable).  
The other course was on the pediatric and adolescent athlete.  I may post in the future on these athletes but for now, suffice it to say that injuries are increasing in this population due to year- round play and higher expectations that come with specialization in a single sport at a younger age.  I feel strongly that kids should play multiple sports for years (at least well into high school).  Anyway, the course discussed common injuries at the elbow, forearm and wrist, and hand.  Interesting topics and discussion.

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