Disorders of the Wrist - Mayo Clinic

Mayo School of Continuous Professional Development 

DISORDERS 

OF THE WRIST 

May 24-26, 2013 

Heritage Hall, Kahler Grand Hotel 

Rochester, Minnesota 

Pre-Conference Laboratory Workshop 

ANATOMY OF THE WRIST 

May 23, 2013 

REGISTER ONLINE NOW! 

www.mayo.edu/cme

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: 

• 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 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 

for Continuing Medical Education to provide continuing medical education for 

physicians. 

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. 

Exhibits will be available for viewing at all scheduled breaks.


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 stateof-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/cme 

Mayo School of Continuous E-mail: cme@mayo.edu 

Professional Development Phone: 800-323-2688 or 507-284-2509 

Plummer 2-60 Fax: 507-284-0532 

200 First Street SW 

Rochester, 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 (cme@mayo.edu 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.


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 Hotel 

20 Second Avenue SW 

800-533-1655 or 507-282-2581 

$102/$129 deluxe king/executive king 

Rochester Marriott Hotel 

101 First Avenue SW 

877-623-7775 or 507-280-6000 

$143 single/double 

DoubleTree Hotel 

150 South Broadway 

507-281-8000 

$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.


FACULTY 

Course Directors 

Richard A. Berger, M.D., Ph.D. 

Professor of Orthopedics 

Department of Orthopedic Surgery 

Mayo Clinic 

Steven L. Moran, M.D. 

Professor and Chair Plastic Surgery 

Professor of Orthopedic Surgery 

Mayo 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 Surgery 

Iowa City, Iowa 

Gregory I. Bain, Ph.D., FRCS 

Modbury Medical Centre 

North Adelaide, South Australia 

Martin I. Boyer, M.D., FRCS 

Washington University School of 

Medicine 

St. Louis, Missouri 

Marc Garcia-Elias, M.D., Ph.D. 

Institut Kaplan 

Barcelona, Spain 

Michael Hayton, FRCS(TrOrth) 

Wrightington Hospital 

Lancashire, United Kingdom 

Guillaume Herzberg, M.D., Ph.D. 

Edouard Herriot Hospital 

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

PROGRAM SCHEDULE 

Thursday, Mayo 23, 2013 

Pre-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) 


8:00 a.m. Lecture: Anatomy of the Wrist 


9:00 a.m. Lecture: Surgical Approaches to the Wrist 


9:30 a.m. Refreshment Break 

9:45 a.m. Dissection: Dorsal Surgical Exposures & Dorsal Wrist Anatomy 

Faculty & Laboratory Staff 

12:00 p.m. Lunch 


1:00 p.m. Dissection: Palmar Surgical Exposures, Palmar Wrist Anatomy, & 

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, 2013 

General Session – Disorders of the Wrist 

6:30 a.m. Breakfast 


7:30 a.m. Welcome and Course Overview 


Session I: The Painful Wrist – Where Do I Start? 

Moderator: Steven L. Moran, M.D. 

7:30 a.m. Introduction and Case Presentation 


7:35 a.m. Examination of the Wrist 


7:50 a.m. Radiology in the Diagnosis of Radial Sided Wrist Pain. The Validity of 

MRI and MR Arthrography 


8:05 a.m. Arthroscopy: Anatomy and Pearls for Diagnostic Accuracy 


8:20 a.m. Case Wrap Up and Audience Vote on Treatment 


Session II: Soft Tissue Trauma – Scapholunate Dissociation 

Moderator: Peter C. Amadio, M.D. 

8:30 a.m. Case Presentation, Overview, Classification, Natural History 


8:35 a.m. Scapholunate Injury: Kinematics and Classification 

Marc Garcia-Elias, M.D., Ph.D.


9:00 a.m. Closed and Arthroscopic Options (Pinning, Shrinkage) - When Will It 

Work? Grade 2 and 3 Instability 


9:15 a.m. Dynamic Instability and the Role of Capsulodesis 

Robert M. Szabo, M.D., MPH 

9:35 a.m. Tenodesis 


9:50 a.m. Tenodesis, Suture Augmentation, and Intra-Articular Screws 


10:05 a.m. Case Discussion & Review of Audience Response 



Session IIIA: Acute Scaphoid Fracture 

Moderator: Alexander Y. Shin, M.D. 

10:30 a.m. Case Presentation, Overview, Classification 


10:45 p.m. Radiographic Assessment, MRI, CT, Bone Scan 


11:00 a.m. Casting Versus Screw: When and Who 


11:15 a.m. Surgical Demonstration: Arthroscopic Reduction and Screw Fixation 


11:30 a.m. Proximal Pole Fractures: Avoiding Non-Union 


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 



Session IIIB: Scaphoid Nonunion 

Moderator: Alexander Y. Shin, M.D. 

1:15 p.m. Case Presentation, Overview, Classification, Natural History 


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 


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 


2:30 p.m. The Medial Femoral Condyle 

Alexander Y. Shin, M.D., FRCS 

2:40 p.m. Articular Grafts Free and Vascularized 


2:50 p.m. Case Wrap-Up and Review of Audience Response 


3:00 p.m. Refreshment Break


Session IV: Perilunate and LT Injury 

Moderator: Peter M. Murray, M.D. 

3:20 p.m. Overview and Case Presentation 


3:35 p.m. Greater Arc Variants 


3:50 p.m. Management and long-term outcomes 


4:05 p.m. LT Instability 


4:20 p.m. Axial Carpal Injuries 


4:35 p.m. Pisotriquetral Problems 


4:50 p.m. Case Discussion 



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 Arthritis 

Moderator: David J. Slutsky, M.D. 

7:30 a.m. Wrist Salvage-Overview, Case Presentation: SLAC SNAC and 

Radiocarpal Arthrosis 


7:45 a.m. 4-Corner 


8:00 a.m. PRC 


8:15 a.m. Radiolunate Fusion 


8:30 a.m. Radioscapholunate Fusion 


8:45 a.m. Arthroscopic Management of Arthritis 


9:00 a.m. Bone Shape and Carpal Mechanics: Distal Pole Resection 


9:15 a.m. Wrist Replacement 


9:30 a.m. Wrist Replacement: Long Term Outcomes 


9:45 a.m. Wrist Replacement and Hemi Wrist Arthroplasty 

Brian D. Adams, M.D., Ph.D.


10:00 a.m. Neurectomy 


10:10 a.m. Case Discussions and Questions 



Session 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 


11:00 a.m. Pathoanatomy and Kinematics of TFCC and DRUJ 


11:20 a.m. Diagnostic Arthroscopy: Midcarpal Instability 


11:35 a.m. Surgical Approach to the Ulnar Aspect of the Wrist 


11:50 a.m. Case Discussion 

Martin I. Boyer, MD, Ph.D. 


Session VII: TFCC Injury 

Moderator: Bassem T. El Hassan, M.D. 

1:00 p.m. Overview and Anatomy 


1:10 p.m. TFCC Injuries, My Repair Technique 


1:25 p.m. Arthroscopic Management of TFCC Tears, Wide Awake Surgery 


1:40 p.m. UT Split Tears 


1:55 p.m. Impaction 


2:25 p.m. Failures and Recurrent TFCC Tears 





Session VIII: DRUJ Injuries and DRUJ Salvage 


3:15 p.m. Case Presentation, Overview, Natural History 


3:30 p.m. Acute Dislocations and Galeazzi fractures 

Brian T. Carlsen, M.D. 

3:45 p.m. Chronic Instability 


4:00 p.m. Herbert Distal Ulnar Head Replacement 


4:15 p.m. Hemi Endoprosthesis 


4:30 p.m. Total Ulnar Head Prosthesis 

Richard A. Berger, M.D., Ph.D.


4:45 p.m. Salvage of Failed DRUJ Reconstruction: Darrach and the 

One Bone Forearm 


5:00 p.m. It’s Not the Wrist; It’s the Elbow 

Scott P. Steinmann, M.D. 

5:15 p.m. Madlung’s Deformity 


5:30 p.m. Pediatric DRUJ 




6:00 p.m. Conference Reception & Exhibits 

Sunday, May 26, 2013 



Osseous Trauma: Distal Radius Fracture 


7:30 a.m. Case Presentation, Overview, Classification 


7:45 a.m. Distal Radius Anatomy 


8:00 a.m. Volar Plates 


8:15 a.m. Fragment Specific Fixation 


8:30 a.m. Dorsal Plating-Is There Still a Role? 


8:45 a.m. Distal radius fracture:An evidence based approach 

Robert M. Szabo, M.D., MPH 

9:00 a.m. Intramedullary Cage 


9:15 a.m. Bridge Plate 


9:30 a.m. Arthroscopic Management of Pain Following DR Fractures 



10:15 a.m. Bone Grafting: When and With What 


10:45 a.m. Arthrodesis: The Ultimate Salvage 


11:00 a.m. Malunions 


11:15 a.m. Case Discussion and Questions 


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 


12:30 p.m. Adjourn

REGISTRATION FORM 

Disorders of the Wrist 

2013R852 

May 24-26, 2013 

Heritage Hall, Kahler Grand Hotel • Rochester, Minnesota 

Mail form and payment to: 

Mayo School of CPD Phone 800-323-2688 or 507-284-2509 

Plummer 2-60 FAX 507-284-0532 

200 First Street SW E-mail cme@mayo.edu 

Rochester, MN 55905 Web site www.mayo.edu/cme 

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

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Please 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 

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REGISTER TODAY! 

MAYO CLINIC 

200 First Street SW 

Rochester, MN 55905 

Mayo School of Continuous Professional Development 

DISORDERS 

OF THE WRIST 

May 24-26, 2013 

Heritage Hall 

Kahler Grand Hotel • Rochester, Minnesota 

Pre-Conference Laboratory Workshop 

ANATOMY OF THE WRIST 

May 23, 2013 

If you already received a copy of this brochure, please give 

to an interested colleague. 

© 2012 Mayo Foundation for Medical Education and Research 

MC8020-78

Disorders of the Wrist - Mayo Clinic

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