Hand Association News
Spring 2020

Working together to advance global hand care and education




Message from the AAHS President: Nash Naam, MD

Nash Naam, MD
Nash Naam, MD
AAHS President

The Coronavirus pandemic has invaded all corners of the world. It is having a significant impact on all aspects of medical care everywhere. Most of us do not perform elective surgeries in order to maintain our resources to serve those infected with this virus.

Many medical conventions have been cancelled at least for the next few months. All of us hope to get back to some normalcy sooner than later. But the safety and the health of our patients and our citizens have to be the first important objective that we should concentrate on before any type of normality comes back.

This cruel pandemic re-introduced the real heroes in our societies namely, the physicians, nurses, respiratory therapists, lab technologists and others who are at the front line doing extraordinary heroic acts defending our citizens against this dreadful virus pandemic. We salute all of you who are putting your lives on the line to protect, treat and support patients with Coronavirus.

As the situation of this pandemic is very fluid and things are changing almost hourly, AAHS, has been trying to be on the forefront of this battle by informing our members of the important issues relevant to their practices. Periodic emails will be sent to our members outlining relevant data and recommendations from our larger sister organizations such as the American College of Surgeons, the American Medical Association and the American Academy of Orthopedic Surgeons, as well as Center for Disease Control and Prevention.

As most of us are hunkering down at home being unable to travel to attend medical conferences, AAHS has strived to ensure continuation of hand surgery education during these unsettling times. Our educational committee Chair, Josh Abzug, MD, has pioneered an initiative to provide our members with online-based education in form of Webinars. These Webinars, which run every Sunday evening, are free to our members and are geared towards residents and fellows as well as hand therapists and advanced providers. Our thanks and appreciation are extended to Josh and his committee, and to the webinar faculty: Joshua Abzug, MD, Don Bae, MD, Andrea Bauer, MD, Roger Cornwall, MD, Kyle Eberlin, MD, John Fowler, MD, Martin Herman, MD, Jonathan Isaacs, MD, John Herzenberg, MD, Christine Ho, MD, Scott Kozin, MD, Dawn LaPorte, MD, Suhail Mithani, MD, Amy Moore, MD, Terry Light, MD, Kevin Little, MD, Heather Lochner, MD, Scott Oishi, MD, Peter Rhee, MD, Julie Samora, MD, Carley Vuillermin, MD, Theresa Wyrick, MD, Dan Zlotolow, MD. The Webinars have been very successful with registration numbers in the 500’s and 600’s. Josh and his committee are planning to continue this series of free webinars through, at least, the end of May.

Our program committee under the capable direction of our program chairs: Julie Adams, MD and Mark Rekant, MD are working hard along with Vanessa Smith, PA-C and Cindy Ivy, OTR/L, CHT and Crystal Beatrice, our meeting manager, to create a memorable meeting in Kauai, in January. AAHS leadership will be continuously evaluating Coronoavirus related impacts on our communities and the healthcare system as we prepare for the meeting in Kauai. The membership will be updated as we approach January 2021.

Again, I would like, on your behalf, to extend our deep thanks and appreciation for the continued excellent work to our Executive Director: Sarah Boardman and Crystal Beatrice, Angela Silvestri, Aviana Fiore and Yvonne Grunebaum.

I wish you all the best in the coming weeks and months. Stay vigilant and continue to do your excellent work to help our patients and our communities. Usually, in tough times, the quality and the commitment of our members working day in and day out to help our patients shine brilliantly more and more. I am really very proud and very grateful to be the President of such a vibrant and relevant organization.

Keep up the great work!

Please feel free to email me at any time. I would welcome any comments or questions.

Please stay safe and healthy.

Sincerely,
Nash Naam, MD
nashnaam@gmail.com




Free Webinars During COVID-19 Crisis

The AAHS is offering FREE weekly, educational webinars for residents and fellows as well as hand therapists and advanced practice providers to facilitate ongoing education during the COVID-19 crisis. These webinars will take place on Sunday evenings and will also be recorded for later viewing. Register for upcoming webinars and view recording webinars on the AAHS website.

AAHS Webinar: Brachial Plexus Injuries
Sunday, May 10, 2020, 7:00 – 8:00 PM Eastern Time
Register for this webinar
AAHS Webinar: Distal Radius Fractures
Sunday, May 17, 2020, 7:00 – 8:00 PM Eastern Time
Register for this webinar
 
AAHS Webinar: Carpal Instability
Sunday, May 24, 2020, 7:00 – 8:00 PM Eastern Time
Register for this webinar
AAHS Webinar: Adult Carpal Fractures and Dislocations
Sunday, May 31, 2020, 7:00 – 8:00 PM Eastern Time
Register for this webinar



Best Hercules or Holmes Case

During the 2020 Annual Meeting, AAHS debuted a new session, “Best Hercules Cases vs. Best Holmes Cases.” This session was moderated by the expert panel of judges of team of Drs. Mark Baratz, Jeff Greenberg, and Amy Moore, and the best cases submitted to this competition were presented to the AAHS audience. After critique, the audience decided 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. In this issue of Hand Association News and in the subsequent issues this year, these cases will be featured. The Hercules winner is featured in this issue!

Read more on Size Matters Not: Youngest Functional Muscle Transfer for Restoration of Hand Function in a Four Month Old Infant


Therapist Corner:
Does Botox for migraine on EDS or hyper-mobility syndrome patients set them up for future problems?

Saba Kamal, OTR, CHT
Saba Kamal, OTR, CHT

What is Migraine?
Migraine is more than a headache. It is a distinct neurological disease that changes brain biology and function.

Migraine is a long-term disabling disease that can profoundly impact someone’s ability to carry out everyday activities like attending family events or going to work. Migraine can also be difficult on family members—partners, parents, children and relatives.

How does Botox help for Migraine?
The pathomechanism of chronic migraine has not been fully elucidated. The mode of action of onabotulinumtoxinA in the treatment of chronic migraine is suggested to be related to the inhibition of the release of calcitonin gene-related peptide and substance P in the trigeminovascular system. Randomized clinical trials demonstrated that long-term onabotulinumtoxinA fixed-site and fixed-dose (155-195 U) intramuscular injection therapy is effective and well tolerated for the prophylactic treatment of chronic migraine.

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Abstract Submission Open

2021 Annual Meeting
The abstract submission site for the Hand Association's 2021 Annual Meeting in Kauai, Hawaii is now open. Please prepare to submit your best work! The deadline for submissions is July 12, 2020.

Join AAHS on Social Media!

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The AAHS Technology Committee and Social Media Subcommittee have relaunched the Hand Association’s social media accounts! Join us on social media!



Recommendations from an AAHS Member on the Garden Isle of Kauai
Alyssa Carnegie, MD
Alyssa Carnegie, MD

The island of Kaua’i, also known as the Garden Isle, has the honor of hosting the AAHS Annual Meeting in January of 2021. As a resident of the island for the past 5.5 years, I’m excited to share with you some of the sights, scenes and activities that await you. By briefly introducing you to this, the most beautiful of the Hawai`ian islands (a clearly biased opinion), I hope to provide even a brief but welcome distraction from the challenges we all currently face together in the midst of the COVID-19 pandemic.

There is much to see, do and enjoy outside of the host location, The Grand Hyatt Resort & Spa! Although, to be fair, for anyone who hasn’t stayed at the Grand Hyatt, the hotel is itself is a treat with the most incredible pool, beautiful gardens and Pacific Ocean views that are unrivaled.

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2019 Vargas Recipient Report: Kumasi, Ghana
Lisa Flewelling, MscOT, BscOT

My name is Lisa Flewelling, MscOT, BscOT. I am an occupational therapist who works in hand therapy as a valued member of a wide-awake hand surgery team at my home hospital the Saint John Regional Hospital in New Brunswick, Canada. My Vargas outreach trip took me to Kumasi Ghana, for 2 weeks in early September 2019. This trip was a return trip to Kumasi: I visited in the same capacity as a therapist volunteer with Health Volunteers Overseas in 2016.

Presently onsite in Kumasi at the Komfo Anokye Teaching Hospital (KATH) there are 2 physiotherapists who are serving in the capacity of Lisa Flewelling, MscOT, BscOT hand therapists: Robert Sowa and Pokuaa Asamoah. These two therapists were working with this service during my visit in 2016 as well. The hand therapy site collaboration with HVO began in 2014.

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Reserve Commander Receives Humanitarian Award

Dr. Miguel Pirela-Cruz
Dr. Miguel Pirela-Cruz
Longtime AAHS member Dr. Miguel Pirela-Cruz was honored as the Hand Association’s 2020 Humanitarian Award recipient at the January meeting in Ft. Lauderdale for living a life of putting service before self through his work with Guatemala Healing Hands Foundation and in his military service. Dr. Cruz was again recognized through a publication issued by the Dobbins Air Reserve Base. Congratulations and thank you, Dr. Pirela-Cruz!

Share Your Articles from HAND

HAND Did you know that you can send links of interesting HAND articles to your friends, colleagues, and residents even if they don’t have a subscription to HAND? The following power point will guide you through these steps.

Access Sharing and e-Reacher on SAGE Journals


Reserve Commander Receives Humanitarian Award

Dr. Miguel Pirela-Cruz
Dr. Miguel Pirela-Cruz
Longtime AAHS member Dr. Miguel Pirela-Cruz was honored as the Hand Association’s 2020 Humanitarian Award recipient at the January meeting in Ft. Lauderdale for living a life of putting service before self through his work with Guatemala Healing Hands Foundation and in his military service. Dr. Cruz was again recognized through a publication issued by the Dobbins Air Reserve Base. Congratulations and thank you, Dr. Pirela-Cruz!



Share Your Articles from HAND

HAND Did you know that you can send links of interesting HAND articles to your friends, colleagues, and residents even if they don’t have a subscription to HAND? The following power point will guide you through these steps.

Access Sharing and e-Reacher on SAGE Journals



A Letter from the Editor

John Fowler, MD
John Fowler, MD
Editor, Hand Association News

With spring upon us, we enter a season of uncertainty. The novel coronavirus has disrupted the global economy, led to the cancellations of major conferences, and even resulted in universities transitioning to online classes. We have witnessed the stockpiling of toilet paper and disinfectant wipes. Stores are completely sold out of hand sanitizer and hospitals have been forced to deal with a shortage of facemasks. The fear of the impending pandemic has and will continue to affect our daily lives.

In these uncertain times, the field of hand surgery holds in interesting place. We are very rarely involved in life or death situations. Most of what we do is focused on improving the quality of life of our patients rather than saving it. There are serious discussions at my institution and many others about whether it is appropriate to continue performing elective surgeries and seeing patients in the office for non-traumatic/non-urgent hand and upper extremity conditions. This situation is very fluid and even as I write this, we are unsure what the next weeks and months may bring. My sincere hope is that we can look back on this letter and laugh about how silly it was that we have restricted the gathering of large groups and considered pausing elective treatments. Time will tell.

Whenever these types of events occur, it always reminds me of just how short and precious life really is. It makes me want to hug my wife and kids a little more tightly and cherish the moments that we have together as one never knows what tomorrow may bring. I hope that everyone who reads this remains safe and healthy.

Sincerely,
John Fowler
John Fowler, MD




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