2009-2010 Annual Report - UC Davis Health System

Hand and Upper Extremity ServiceRobert M. Szabo, MD, MPHProfessor, Chief andFellowship DirectorRobert H. Allen, MDAssociate Clinical ProfessorThe intricate design and frequent useof our hands and upper extremities eachday makes this part of our bodies highlysusceptible to injury and disease. TheUC Davis Orthopaedic Hand & UpperExtremity Service specializes in treatingpatients with common and complex,traumatic and acquired disorders of thehand and upper extremity. Our teamcombines the best in clinic, educationand research for our patients.We have experience and expertise in a widerange of conditions, such as arthritis ofthe hand; trigger finger; fingertip injuriesand amputations; intersection syndrome;DeQuervain’s tenosynovitis; compresssionneuropathies; Dupuytren’s Disease; tumorsof the hand; and the hand in cerebral palsy,just to name a few. Common proceduresperformed are brachial plexus and peripheralnerve surgery; congenital deformities,including Ilizarov reconstructions; shoulder,elbow and wrist joint replacements; wristreconstruction, including arthroscopy;tumors; and microvascular reconstructivefree tissue transfers.The Hand & Upper Extremity Serviceattracts patients from the entirety ofnorthern California, southern Oregon,and western Nevada, with private patientstraveling from New York, New Orleans,Washington State and Mexico. The serviceperforms over 600 procedures each year.We have a strong relationship with theJapanese orthopaedic and hand surgerycommunity. Hand Service faculty havebeen invited to lecture in Japan on twoseparate occasions. In September 2009,two ASSH International Japanese TravelingFellows visited our service. In addition, adistinguished Japanese hand surgeon fromKagawa came to observe Dr. Szabo for theentire month of November 2009. The onlyother centers this surgeon visited in the USwere the Mayo Clinic and Harvard.Our primary research focus, both clinicallyand in the laboratory, is on nerve compressionsyndromes. A major emphasis on earlylaboratory efforts has focused on examiningthe effect of compression on the tibial nerveon a rat model. Specific aim had been tocharacterize the response of peripheralnerves to intermittent compression with agoal of understanding the role of repetitivemotion, as seen in cumulative trauma, inthe pathophysiology of nerve compression.In the laboratory, an animal model wasdeveloped to study end-to-side nerveregeneration through silicone tubules andexamine the effects of growth factors onnerve regeneration and repair. Anotherresearch focus is biomechanics of fracturefixation specifically with determining therole of locking, non-locking and hybridfixation in the hand. In addition, Dr. Szabohas a strong interest in clinical researchdesign and outcome studies that can contributeto the foundation of evidence-based medicine.The following are highlights for the pastfiscal year:• In March 2010, the Hand Service wasawarded a fellowship grant for $25,000from the Orthopaedic Research andEducation Foundation (OREF) forfellowship year 2010-2011.• Dr. Szabo assumed the role of Presidentof the Americfan Society for Surgery ofthe Hand (ASSH) in September 2009.He will serve until October 2010 andwill preside over the 65th Annual ASSHMeeting in Boston, MA, October 7-9.• In September 2009, Dr. Szabo receivedan Honorary Member Award from theAmerican Society of Hand Therapists(ASHT).• Dr. Szabo was recognized as one ofAmerican’s Top Doctors for Cancerby Castle Connolly Medical, Ltd. inNovember 2009.• In April 2010, Dr. Szabo was recognizedfor his distinguished contributions as aspeaker at the 53rd Annual Meeting ofthe Japanese Society for Surgery of theHand (JSSH).