This course will offer guidance on treatment strategy from Chinese experts with experiences in large number of tough cases of congenital hand deformities. The topics include treatment strategy and outcome analysis from a large cohort Chinese macrodactyly cases; reconstruction of Blauth IIIb and IV hypoplastic thumb by non-vascularized or vascularized metatarsal graft; and the modified technique of pollicizaton for floating thumb. The techniques for the functional reconstruction will be discussed and the common result will be reviewed.

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

1. Update the latest stage of treatment of congenital hand deformities in China.
2. Discuss the treatment strategy for rare congenital cases.
3. Modify current surgical strategy and improve treatment outcome.

This course will discuss the various upper extremity overuse injuries that occur when children participate in certain sports activities. Discussion of prevention as well as the treatment, including conservative and operative techniques, of the injuries will occur. Details regarding the role of therapy will be highlighted.

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

1. Discuss closed and operative management of pediatric upper extremity sports related overuse injuries.
2. Identify potential complications, as well as their prevention and treatment, surrounding pediatric upper extremity sports related overuse injuries.
3. Identify therapeutic modalities, including splinting, as well as return to play programs for pediatric upper extremity sports related overuse injuries.

Distal radius fractures are common in practice. In addition many fractures are fragility fractures and represent an opportunity to evaluate and intervene for patients with osteopenia or osteoporosis, and a potential for fracture prevention. This ICL will discuss evaluation and management of challenging distal radius fractures, the current evidence and cutting edge treatment strategies, and share strategies for optimizing care (operatively and nonoperatively) by incorporation of a multidisciplinary care program including NP/PAs and hand therapy.

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

1. Describe postoperative interventions for patients with distal radius fractures.
2. Discuss concept and evaluation and treatments of fragility fractures Explore opportunities for the APP to develop bone metabolic programs.
3. Describe treatment options for especially challenging distal radius fractures

Education is a dynamic and evolving process. This instructional course will focus on current topics in educating students, residents and fellows for an upper extremity practice. The core principles of adult learning will be reviewed including fostering active learning, providing learner appropriate material and avoiding cognitive overload. Core program principles will be presented including focusing on learning not teaching, and recognizing the hidden curriculum. Surgical simulation has become an innovative method of teaching surgical skills and validating competence outside the operating theater. Strategies will be reviewed in performing this metric based evaluation. Novel and efficient methods of the evaluation of skills and knowledge will be presented. Mentoring is critical component in preparing young practitioners. The stages of mentoring and the traits of highly effective mentors will be discussed. Time will be allotted for a discussion of the barriers to effective teaching and learning.

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

1. Determine barriers to effective teaching and learning.
2. Describe teaching methods to foster active learning.
3. Define the aspects of an effective mentor 4.List metrics to improve skills evaluation.

The planning, timing and execution of secondary procedures in replanted segments permits the upgrading of functional results and are central to the indication itself of these complex cases.

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

1. Discuss early planning of secondary procedures in replantation.
2. Identify the role of this planned secondary surgery in the indication itself of the replantation.
3. Identify the role of ectopic temporary replantation.

Assessing and treating failed nerve surgery is a daunting challenge for even the most experienced surgeons. Temporal nerve and muscle degeneration further complicate the decision tree. Unsuccessful nerve regeneration following repair or neurolysis can be related to technical or physiological issues and a thorough understanding of these is essential in analyzing correctible causes. This ICL will explore the reasons for failed nerve repair, carpal tunnel release, and cubital tunnel release and offer detailed guidance in assessing and treating the different scenarios. Neuromas offer their own unique challenges and often result from failed nerve repairs or are a complication of nerve decompression surgery. Many neuromas are recalcitrant to initial treatment efforts. Advanced strategies to address persistent neuromas will be discussed as well.

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

1. Assess failed nerve repairs and define treatment options.
2. Differentiate between failed nerve decompression, recurrent nerve entrapment, and incomplete nerve release.
3. Describe treatment strategies to address recurrent nerve entrapment.
4. List treatment options for persistent neuroma pain.

As reimbursements decline and overhead costs continue to rise, physicians, especially those in private practice, are finding it more difficult to maintain an operating margin that allows them to continue to deliver quality care to patients while maintaining their desired standard of living. Many models solve this by increasing patient volume, which either means increased hours spent in office or less time spent with patients. Unfortunately, it often means both. New policies, in particular those introduced by the Centers for Medicare and Medicaid Services (CMS), often add to the burden of practice by requiring additional information gathering, strict adherence to new coding systems and meticulous documentation. These new requirements may stress the system by overwhelming patients with paperwork, slowing patient flow and sometimes leading to denied payment. If we are to continue to deliver quality care to our patients while ensuring value and satisfaction, we must find ways to eliminate waste and minimize redundancy. In short, we must learn to do more with less. This instructional course lecture is intended to provide the audience with tools to study their office processes, identify potential blocks to efficiency, discuss common issues and explore potential solutions.

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

1. Discuss trace the flow of patients through their office from booking appointments to check out.
2. Describe common impediments to efficient patient flow and learn what has worked for others.
3. Recognize and evaluate the value of various means of meeting documentation requirements, including electronic and human solutions, and learn how to choose the optimal solution for their specific practice scenario.
4. Identify other areas of increasing efficiency, such as shifting work from the point of patient contact

Joint stiffness or arthrofibrosis is one of the few unsolved problems in upper extremity surgery which severely limits the functional outcomes following upper extremity surgery and traumatic injuries. The field has notices marginal improvements over the past 3-4 decades but innovation has certainly lagged behind that of reconstructive surgery and bony fixation. We hope to introduce therapeutic modalities, operative techniques at the time of index procedures, as well as innovative approaches during subsequent interventions to optimize patient outcomes.

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

1. Describe pathophysiology and epidemiology of joint stiffness Screen for and identify at risk patients and implement early interventions.
2. Discuss principles and operative techniques during index procedures to minimize joint stiffness.
3. Describe various classic and innovative approaches to the treatment of joint stiffness.
4. Identify perioperative protocols utilized to decrease joint stiffness.
5. Describe therapeutic techniques and modalities to decrease joint stiffness.

Who is responsible for our patient outcomes? Why does excellence matter? At the end of the presentation, the audience will have a better understanding of the dynamic nature of shared leadership, the teamwork required for optimal outcomes, and why the excellence experience matters for our patients.

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

1. Describe the significance of the excellence experience.
2. Identify the elements of teamwork required to orchestrate optimal outcomes.
3. Appreciate and discuss the dynamic nature of shared leadership.

This fun-filled fifteen minutes will elucidate which audience member has the highest Hand IQ. A series of trivia questions will slowly eliminate wrong responders until only one remains to take home the prize. Will you be the last person standing?

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

1. Identify the Last Person Standing.
2. Discuss informational Q&A and boards style questions.
3. Discuss hand anatomy and pathophysiology.

The course will review current literature regarding physician burnout and stressors. It will also review up to date information on how to succeed in stressful careers and situations. The course will provide practical information/recommendations for each attendee to implement to improve their job and life satisfaction and success.

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

1. Discuss physician burnout-rates and causes of.
2. Identify current recommendations from medical community regarding preventing burnout.
3. Identify current recommendations from research regarding best practices to be successful in stressful jobs, situations, and careers

Upper limb amputation is a devastating condition. While there is a standard in managing this condition in the USA, e.g. no replantation of a single (non-thumb) amputation, patients and surgeons in different parts of the world may choose to manage it differently, based on their cultures and socioeconomic backgrounds,. With the new advances in technology and techniques, more options are available for use. Our presenters from all around the world, i.e. Germany, Austria, Hong Kong and China, aims to use case based discussion to illustrate the different management protocol around the world.

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

1. Recognize the differences in management of finger amputation around the world.
2. Discuss the reconstructive procedures available after finger amputation
3. Discuss the new advances in the management after major upper limb

A panel of AAHS past presidents will discuss early beliefs and practices that changed over time as a result of wisdom gained and lessons learned. In doing so, they will highlight the importance remaining open-minded and self-reflective and will also share pearls that will be useful to the practicing hand surgeon.

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

1. Discuss the evolving nature of hand surgery
2. Identify practice recommendations from expert hand surgeons

Innovation continues to play an important feature of hand surgery and the specialty has continued to see the ingenuity and efforts of many of its members to produce surgical procedures and new technologies to help resolve clinical challenges. Yet the potential for these innovations to prove ineffective or even dangerous also represents a challenge.

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

1. Discuss characteristics can be identified in some of our noteworthy innovators.
2. Identify some of the very important innovations that have made major impacts over the past two decades.
3. Discuss challenges that exist to assure the safety of a new innovation.

For this presentation, traumatic elbow injuries are defined as fractures and/or dislocations affecting the articulations of the elbow complex. The common conditions that may occur as a result of a traumatic elbow will be addressed including joint stiffness, nerve injury, and instability. Recommendations for evidence-informed therapist's examination and treatment the will be reinforced through case examples and clinical tips.

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

1. Describe anatomy and biomechanics of the elbow/forearm complex including the course of the peripheral nerves vulnerable with traumatic elbow injuries.
2. Employ clinical examination techniques to identify peripheral nerve injuries and causes of movement dysfunction.
3. Formulate a plan of care with targeted interventions to management post-traumatic stiffness of the elbow to restore a functional arc of motion.
4. Formulate a plan of care to address other factors associated with movement dysfunction to optimize functional outcomes.

The AAHS Surgical Skills Workshop is a course designed to provide participants an opportunity to learn techniques for internal fixation and technical pearls in wrist and hand fractures from an expert faculty panel and put them into practice in a hands-on sawbone workshop.

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

1. Demonstrate on a saw bone model the application of basic principles of lag screw fixation, neutralization plate, and compression plating in hand fractures.
2. Recognize fracture patterns and plan reduction of distal radius and perform volar plating n a distal radius sawbone model.
3. Discuss surgical options for management of articular fractures and dislocations in the hand and perform them in sawbone model.
4. Explain indications and demonstrate technique for fixation of scaphoid fractures in a sawbone model.

Teams of 4-6 will 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.

Major breakthroughs have been achieved in both hand surgery and microsurgery for the last decade in china. In this course, we will review recent research and representative clinical achievements and discuss future challenges. The course will also review the relevant concepts of anatomy and pathology as well as treatment methods relating to wrist and hand surgery. The faculty are recognized experts in hand and microsurgery from china and have been selected for their knowledge, expertise and contributions relating to the subject.

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

1. Discuss different approaches for the treatment of hand and upper extremity trauma including bony and soft tissue injury.
2. Assess the related anatomy, surgical approaches and clinical outcomes relating to peripheral nerve problem for upper extremity.
3. Determine appropriate treatments for acquired, traumatic, inflammatory and degenerative disorders of the wrist joint.

The masquerading of TOS by various other nerve symptoms, wrist and shoulder pain will be discussed along with awareness of it being much more common is swimmers and athletes than appreciated and then how to treat it and why it should be done by hand/upper extremity surgeons. Major breakthroughs have been achieved in both hand surgery and microsurgery for the last decade in china. In this course, we will review recent research and representative clinical achievements and discuss future challenges. The course will also review the relevant concepts of anatomy and pathology as well as treatment methods relating to wrist and hand surgery. The faculty are recognized experts in hand and microsurgery from china and have been selected for their knowledge, expertise and contributions relating to the subject.

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

1. Recognize Thoracic Outlet Syndrome.
2. Discuss how to treat TOS both conservatively and surgically.

Musculoskeletal ultrasound is becoming more widely used at the point of service by hand and upper extremity surgeons. One of the biggest barriers to increased utilization is lack of understanding of how to get started and lack of clarity on how to bill for services. This course will review the many uses for musculoskeletal ultrasound in the upper extremity and act as a primer for appropriate certification and billing practices.

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

1. Recognize the potential applications of ultrasound in an upper extremity surgeon's practice.
2. Describe the proper billing practices for the use of musculoskeletal ultrasound in an upper extremity practice.
3. Discuss the use of ultrasound for diagnosis of compression neuropathies in the upper extremity.
4. Indentify techniques learned in this course to for diagnosis of rotator cuff tears by ultrasound examination.

Vascular disorders of the hand can be mystifying. Many providers are unsure of what tests to order, and many are intimidated by the nature of the complex interventions that can be performed. This panel will outline the best way to evaluate a patient with vascular insufficiency of the hand, with a focus on which diagnostic tests are the most helpful. Interventions for vasospastic disease (Raynaud phenomenon), acute ischemia, as well as chronic "end-stage" ischemia will be reviewed in detail by surgeon-educators who are very experienced in this field. Real-world cases will be presented for commentary and discussion and Q&A.

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

1. Discuss correct diagnostic tests for the work-up of a patient with vascular disease of the hand.
2. Identify which patients may benefit from the off-label use of botulinum toxin for vasospasm.
3. Identify appropriate reconstruction for patients with acute ischemic disease and/or chronic aneurysms of the hand.
4. Describe the principles behind advanced techniques such as arterialization of the venous system of the hand.

Healthcare is changing from volume based fee for service to value based care with alternative payment models including bundled payments. Healthcare systems, physicians, and patients are being held accountable for escalating and non-sustainable healthcare costs. Deductibles and co-pays continue to increase while reimbursement is decreasing requiring stakeholders to engage in fiscally responsible decision making regarding the cost of delivering care. An increasingly popular approach to cost containment and value based care is a value analysis program which requires the engagement and collaboration of physicians, group practices, healthcare systems, hospitals, and vendors. A successful value analysis program should be standardized, transparent, and without conflict of interest. Physician expectations regarding the process have been identified and should be incorporated into the process. The purpose of this symposium is to familiarize the orthopedic surgeon with the role of the hand surgeon in delivering value, to discuss why they should be involved, and how to implement a robust and impactful program.

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

1. Discuss the role of the hand surgeon in the evolving shift to alternative (value) based payment models.
2. Recognize why a structured value analysis program that is based on patient centered care, evidence based literature, and best practice is both essential and important in your practice and healthcare system.
3. Identify the key features physicians want in a successful value analysis program

This course will briefly cover the history of PIP joint arthoplasaty while focusing on the successes and indication of PIP arthroplasty in 2020. The course will cover indications for silicone, pyrocarbon, metal implants as well as alternatives such as autograft and free joint transfer.

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

1. Disucss indications for PIP joint arthroplasty
2. Discuss benefits and indications for different types of PIP joint arthroplasty.
3. Indentify rehabilitation protocols to maximize function.
4. Describe how to handle most common complications seen.

A review of IOL anatomy with a focus on how to improve surgical outcomes through an understanding of IOL biomechanics. Understanding the IOL and its role in improving surgical outcomes and rehabilitation in the elbow, forearm and wrist. Injuries to the interosseous ligament are unusual, perplexing, and difficult to treat. Although these injuries are primarily recognized with affecting the central band, they can also involve the proximal and distal portion of this ligament complex affecting elbow and wrist function. The course intends to familiarize the surgeon and hand therapist with these problems in order for them to be recognized and adequately treated.

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

1. Identify IOL anatomy (distal oblique ligament, central band, and proximal oblique ligament) and its biomechanical implications on forearm stability
2. Discuss IOL anatomy to improve outcomes in the treatment of distal radius fractures.
3. Review new IOL anatomy to keep you out of trouble in the treatment of ulnar impaction.

This course is the basic to promote knowledge about how to use external fixator on hand.

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

1. Discuss hand anatomy before use of external fixator.
2. Identify indications to use external fixator on hand and technics.
3. Discuss cases, complications and results.

Dr. Chang is the founder of the Pediatric Cardiac Intensive Care Society (PCICS) that launched the multi-disciplinary focus on cardiac intensive care for children. He is also the founder of the Asia-Pacific Pediatric Cardiac Society (APPCS), which united pediatric cardiologists and cardiac surgeons from 24 Asian countries and launched a biennial meeting in Asia that now draws over 1,000 attendees.

The best cases submitted for consideration will be presented and critiqued by an expert panel of judges. The audience will then decide which exhibited the most heroic efforts, surgical prowess, and "brute force" to conquer a formidable challenge and which employed the most clever, cunning, and innovative solution to crack a difficult case.

This will be a course of the most clinically useful evidence based material combined with the instructors’ best tips and tricks to successfully manage metacarpal fractures in the most patient friendly way possible.

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

1. Improve their successful management of some metacarpal fractures non operatively in a very patient friendly manner.
2. Adopt new strategies to make surgical management of metacarpal fractures more successful in their practice
3. Apply the science of the most clinically useful best evidence available in a practical way to provide better safer care.

Upper extremity lymphedema is a dreaded and not uncommon complication from the treatment of breast cancer. Professional hand surgeons with microsurgical skills must be one of the major groups of future lymph surgeons for upper extremity lymphedema. Anatomical and theoretical advances in treating upper extremity lymphedema make it possible to cure upper extremity lymphedema by surgical approaches. In this course, participants understand current surgical approaches for upper extremity lymphedema. After the course, participants have motivations to be future leaders of lymph surgeons with their new insights.

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

1. Discuss how to detect lymphatic vessels in upper extremity.
2. Identify how to perform lymphaticovenular anastomosis for upper extremity lymphedema.
3. Discuss how to perform local and free lymph node transfer for upper extremity lymphedema

An injury to the upper motor neuron results in impaired regulation of motor activity that can manifest as hyper-reflexia or spasticity. This can lead to an imbalance of forces across the joint and result in static or dynamic deformities in the upper extremities. In severe cases, these deformities can result in hygiene issues and markedly decrease quality of life. The goals of surgical reconstruction are to reduce pain, improve hygiene, enhance functionality, and to correct unaesthetic contractures. This course will review the evaluation and management of this unique and underserved patient population. A case-based format will be utilized to illustrate the approach to managing common spastic deformities in the upper extremity based on the functionality of the extremity. Participants will be able to incorporate the techniques discussed into their practice towards the treatment of mild to severe spastic deformities in the upper extremities.

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

1. Explain the impact of upper extremity spasticity on function and quality of life
2. Describe the indications and goals for upper extremity surgery in patients with upper motor neuron syndrome.
3. Recognize the surgical approach to decrease spasticity in the functional and non-functional upper extremity.

The management of scaphoid fractures can be confusing. Which approach should I use, should I use a vascularized none graft? With the ever increasing use of wrist arthroscopy, we will discuss minimally invasive techniques that will Change The Way You Think. Join us for this case based discussion where the faculty will share on decision making pearls and technical tips and tricks in the management of scaphoid fractures and nonunions.

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

1. Describe the general approach in managing scaphoid fractures.
2. Discuss arthroscopic treatment for scaphoid fractures
3. Recognize arthroscopic management for scaphoid fracture sequalae

The faculty will teach the audience different surgical techniques employed when performing a thumb reconstruction with either a toe transplantation or a toe wrap, providing them a better idea of the intraoperative steps, as well as tips and tricks to optimize surgical outcomes.

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

1. Discuss the principles of thumb reconstruction using microsurgery Learn the steps employed in a toe to thumb transplantation
2. Discuss the steps involved in a toe wrap thumb reconstruction
3. Discuss the additional procedures necessary to improve function after the above mentioned procedures

This course will discuss the mechanism of injury and clinical presentation of common hand and wrist injuries in the pediatric patient population. It will include recommendations for early diagnosis and stabilization of these conditions, timing for appropriate treatment in this patient group, and surgical and non-operative management of these injuries. Post-injury and post-operative hand therapy techniques utilized in the pediatric patient population will also be reviewed.

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

1. Identify common pediatric hand and wrist injuries.
2. Learn how to triage and appropriately stabilize these conditions in the acute injury period.
3. Develop operative and non-operative treatment plans for common pediatric hand and wrist injuries, including incorporation of occupational therapy techniques to improve functional outcomes

Compression neuropathy can lead to pain and extremity dysfunction. This course will address aspects of nerve compression syndromes that are challenging with regards to diagnosis and treatment. This group of experts will highlight innovations and opportunities to improve outcomes including diagnostic pearls, supercharge nerve transfers and electrical stimulation.

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

1. Summarize challenges of nerve compression syndromes, including recurrent conditions.
2. Develop a treatment algorithm for patients with compression neuropathies.
3. Learn perioperative strategies, i.e. diagnostic pearls, supercharge nerve transfers, electrical stimulation, to enhance recovery in patients with nerve compression syndromes

High nerve injuries pose a difficult reconstructive challenge. The use of nerve transfers to restore function have become more popular in upper extremity nerve reconstruction; however, the reliability of tendon transfers is still profound. The experts in this course will debate the indications, use and feasibility of these two reconstructive options to maximize outcomes.

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

1. Discuss the indications, risks and benefits of using tendon transfers versus nerve transfers to restoring function after high nerve injury.
2. Develop a treatment algorithm for high nerve injuries.
3. Learn innovative techniques to restore high nerve injuries.

In this lecture, Dr. James Chang will discuss an exhibit at the Cantor Arts Center based on Auguste Rodin's sculptures. This multi-media art exhibit was a unique collaboration between Stanford Hand Surgery, Anatomy, and Art History.
While training in surgery, Dr. Chang saw correlations between the Rodin hand sculptures and actual hand and microsurgery patients he was treating. This concept became the basis for a Stanford undergraduate course where students dissect human limbs and learn reconstructive techniques in order to diagnose and treat Rodin's hands. The Rodin hands have now been scanned, and computer graphics have been used to allow a look inside Rodin's hands. Dr. Chang's lecture will discuss how he uses Rodin's hands for teaching anatomy and surgery. He will make clinical correlations to a specific hand conditions and hand operations.

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

1. Discuss the historical significance of Auguste Rodin's hand sculptures.
2. Identify clinical correlations between Rodin's hands and common hand disorders.
3. Discuss optimal techniques in hand and microvascular surgery

The management of brachial plexus injuries has continued to evolve over the last few decades. This panel of nerve experts will provide a comprehensive update on the management of patients (pediatric and adult) with brachial plexus injuries. This will include the use of nerve transfers in adults and birth related plexus injuries, contralateral C7 transfers, timing of intervention and advances in neuroimaging.

Injuries to the extensor tendons of the hand are common. Each zone of injury has specific therapeutic requirements due the unique anatomy. This course will review the current literature on therapeutic management of the extensor tendons at Zones I-VI. Demonstrations of specific orthoses and therapeutic exercises will be included.

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

1. Identify the specific digit extensor tendon anatomy at zones I-VI.
2. Select the appropriate orthosis for therapeutic postoperative management of extensor tendon injuries depending on the zone of injury.
3. Describe how the yoke or relative motion orthosis can be used for management of specific extensor tendon injuries.

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 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.

Registration for this course is limited to young surgeons that have/will complete their hand surgery fellowship in years 2018, 2019, 2020 and 2021 and are interested in preparing hand surgery cases for their upcoming oral boards examination. Registrants are asked to submit a case in which they have participated as surgeon or assistant. The case submission should include a 1-2 paragraph vignette with x-ray images if needed. The course directors will select the most instructive cases for the course oral boards-style presentation. If selected, the registrant will present the case for oral board examination presentation, questions by the experienced faculty “Board examiners” and questions from the audience. The faculty “board examiners will provide an evidence-based review of each controversial topic for rapid digestion of important Board examination points. In order to best prepare for the oral boards, all attendees, whether presenting or observing, will be able to participate in this small group format.

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

1. Discuss non-operative and operative treatment for various commonly encountered disorders of the hand and wrist.
2. Identify topics and controversies that could be discussed in oral board examinations.
3. Better prepare their case presentations and examination responses for the oral boards.
4. Discuss evidence-based management of hand surgery cases discussed.

Recent advances in technology and surgical techniques is revolutionizing the world of prosthetics. This panel of experts will discuss the science behind the technology and describe avenues to improving function and minimizing complications in patients with limb amputations.

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

1. Learn the scientific basis for neural interfaces and their impact on advancing the field.
2. Develop a treatment algorithm for the patient with an amputation.
3. Understand the surgical options and limitations of prosthetics in 2020.

End to side nerve transfers, both traditional and supercharge, are gaining popularity among nerve surgeons. This panel will discuss the scientific basis for this nerve transfer technique and how best to apply to patients with nerve injuries. From facial palsy to ulnar neuropathy, the panelists will use a case-based format to highlight opportunities of use.

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

1. Discuss the scientific basis for the end to side and reverse end to side coaptations.
2. Learn surgical techniquest to maximize effectiveness with these nerve transfers.
3. Develop an algorithm for the use of end to side nerve transfers to restore function.

We will present the most current approaches to improving prosthetic rehabilitation following limb loss including RPNI and TMR. These discussion will address the indications, surgical approaches, and outcomes following these surgical procedures. In addition, we will discuss the optimal approaches to treat phantom pain, neuroma pain, and CRPS following devastating injuries of the extremities. The goal of the course will be to shed light on all of the approaches available to enhance functional restoration following limb loss.

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

1. Discuss how RPNIs and TMR can be used to prevent and treat painful neuromas and phantom pain.
2. Identify how RPNIs and TMR can be used for prosthetic control.
3. Develop the optimal ways to diagnose a neuroma and how to differentiate it form other pain conditions like CRPS.

Duchenne muscular dystrophy (DMD) is a severe, progressive muscle disease caused by mutations in the Dystrophin gene, which encodes a large intracellular protein that maintains integrity of muscle cell membranes. More than 4,000 DMD mutations have been identified in humans. The majority of mutations are deletions that cluster in hot spots, such that skipping of out-of-frame exons can potentially restore the reading frame of the Dystrophin protein. We have used CRISPR/Cas9 to generate new mouse models of DMD lacking the most prominently deleted Dystrophin exons in humans. To permanently correct DMD by skipping mutant dystrophin exons in postnatal muscle tissue in vivo, we have used adeno-associated virus-9 (AAV9) to deliver CRISPR/Cas9 gene editing components to dystrophic mice, a method we refer to as Myoediting. We have also optimized Myoediting of many types of DMD mutations in muscle cells derived from iPS cells generated from blood samples of DMD patients. In a path toward clinical translation of gene editing for DMD, we have recently restored dystrophin expression of dogs with DMD following systemic administration of gene editing components with AAV9. Opportunities and challenges in the path toward permanent correction of disease-causing mutations responsible for DMD and other monogenic disorders by genomic editing will be discussed.

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

1. Discuss principles of gene editing.
2. Identify the application of this technology to the correction of DMD.