YEAR IN REVIEW
2017-2018
COMPREHENSIVE HAND CENTER INTRODUCTION HAND SURGERY FELLOWSHIP INTERNATIONAL SCHOLARS M-CHOIR & DEAN LOUIS LECTURESHIP T32 FELLOWS ORTHOPAEDIC SURGERY & ASSH TRAVELING FELLOWS VISITING PROFESSORSHIPS MISSION TRIPS 2017 ASSH MEETING AWARD & WELCOME PAs & OTs
3 4-5 6-7 8-9 10 11 13 14 - 15 16 17 18
PLASTIC SURGERY FACULTY Kevin C. Chung, M.D., M.S. Charles B. G. de Nancrede Professor of Surgery Professor of Plastic Surgery and Orthopaedic Surgery Chief of Hand Surgery, Michigan Medicine Assistant Dean for Faculty Affairs Associate Director of Global REACH, University of Michigan Medical School Steven C. Haase, M.D. Associate Professor, Plastic Surgery and Orthopaedic Surgery Associate Program Director, Michigan Medicine Hand Fellowship Medical Director, Wound Care Program and Comprehensive Wound Care Clinic (ACU) Erika Davis Sears, M.D., M.S. Assistant Professor, Plastic Surgery and Orthopaedic Surgery Research Investigator, VA Center for Clinical Management Research Jennifer F. Waljee, M.D., M.P.H, M.S. Associate Professor, Plastic Surgery and Orthopaedic Surgery Co-Director, Michigan Opioid Prescribing Engagement Network
ORTHOPAEDIC SURGERY FACULTY Jeffrey N. Lawton, M.D. Associate Professor, Orthopaedic Surgery and Plastic Surgery Chief, Division of Elbow, Hand and Microsurgery John R. Lien, M.D. Assistant Professor, Orthopaedic Surgery and Plastic Surgery Division of Elbow, Hand and Microsurgery Kagan Ozer, M.D. Professor, Orthopaedic Surgery and Plastic Surgery Division of Elbow, Hand and Microsurgery
Dear Friends, Welcome to another edition of the Michigan Medicine Comprehensive Hand Center newsletter. This past year has been a rather exciting period for the hand program. After close to 20 years of intense discussion with the medical school and the health system, we recently received the official designation by the academic cabinet of the medical school and by the executive committee of the medical school and health system for our Michigan Medicine Comprehensive Hand Center (MMCHC). The hand center will be part of the East Ann Arbor expansion or the so-called second campus for the health system that will include the Comprehensive Musculoskeletal Center and a number of outpatient clinics as well as additional operating room suites. The MMCHC will house the hand surgery team including surgeons, therapists, physiatrists, physician assistants, pain clinic, and a number of other specialties that care for patients with hand and upper extremity disorders. Michigan Medicine has contracted with an architecture firm that is communicating with all the stakeholders to derive a master plan that will be submitted to the Regents for approval. The timeline has not been finalized, but I am confident that in the next few years, a building will be constructed that will be an ambitious and state-of-the-art facility in caring for patients with common and complex hand conditions. I wanted to take this opportunity to welcome our hand center administrator Erika Arndt. Erika has a degree in health administration and recently was running the cardiology clinics at Beaumont Health. After a national search, she was recruited to provide day-today oversight of many facets of the hand program including benchmarking, marketing, and meetings with the planning group as well as the architecture firm. She is also working with me and our team
members on strategies that we can execute to assure that we have a successful launching of the Center and the growth of our hand program. Our annual visiting hand professor, Dr. Michelle Carlson’s visit was a success. Dr. Carlson, from the Hospital of Special Surgery and past treasurer of the American Society for Surgery of the Hand, is one of the most respected hand surgeons in the U.S. The upcoming hand surgery meeting in Boston is an opportunity for all of us to connect with our growing Michigan Medicine alumni at our reception being organized by Dr. Lawton. We look forward to seeing all of our past fellows, residents, international fellows, as well as friends from the U.S. and the international arena who are supporting us. Our hand surgery family is growing and thriving through the unwaivering commitment of our staff and hand surgery faculty. It has been my honor to have the opportunity to lead and work with this dedicated group. I will continue to seek your support and counsel for our hand program and center that will be a lasting reminder of your contribution at the University of Michigan. Go Blue,
Kevin C. Chung, MD, MS
Charles B. G. de Nancrede Professor of Surgery Chief of Hand Surgery, Michigan Medicine Professor, Plastic Surgery and Orthopaedic Surgery Assistant Dean for Faculty Affairs Associate Director of Global REACH
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HAND SURGERY FELLOWSHIP The University of Michigan Hand Surgery Fellowship will be entering its 9th year in 2018, welcoming two new fellows in August: Dr. Phillip Ross from the University of Cincinnati Orthopaedic Program, and Dr. Sarah Sasor from the Plastic Surgery Program at Indiana University. Under the leadership of Drs. Kevin Chung and Steven Haase, our fellowship has grown a lot in the past eight years. Whereas we began with just three teaching faculty, we now have a diverse group of seven faculty hand surgeons. In 2015, we expanded from a single fellow to two accredited fellowship spots. Our devoted, hard-working faculty from both plastic surgery and orthopaedic surgery train fellows in an unique combined program, where we seek to break down barriers between our two departments and simply train our fellows in “Hand Surgery”. This attitude, combined with unparalleled case variety, strong didactic instruction, and mentoring in research, makes our fellowship really stand out among other hand surgery training programs. Dr. Haase, who has been Associate Program Director since the fellowship’s inception, will be stepping up to take over the role of Program Director this year, as Dr. Chung assumes his new leadership role as the Director of the Michigan Medicine Comprehensive Hand Center. Since graduation, our alumni continue to contribute to practices and academic programs throughout the country. Dr. Kate Nellans is currently the Associate Program Director for the Orthopaedic Residency based at Long Island Jewish Hospital in New York. Her practice includes both adults and children at a 4
Year 2012
Year 2011 Nathan S. Taylor, MD
Advanced Center for Orthopaedics Marquette, MI
Jennifer F. Waljee, MD, MPH, MS
Kate W. Nellans, MD, MPH
Year 2015
Year 2016
University of Michigan, Section of Plastic Surgery
Year 2014 Joshua M. Adkinson, MD
University of Indiana, Section of Plastic Surgery
Erika Davis Sears, MD, MS
University of Michigan, Section of Plastic Surgery
Year 2017
Year 2016 Brett Michelotti, MD University of Wisconsin
Kate Elzinga, MD
Current Fellow
Current Fellow
Matthew S. Brown, MD
Midland Plastic Surgery Center Midland, TX
Year 2017 University of California, San Francisco
Year 2018 Brian Kelley, MD
Hofstra Northwell School of Medicine, Orthopaedic Surgery
Paymon Rahgozar, MD
University of Calgary
Year 2018 Xuan (Elizabeth) Qiu, MD
Year 2013
regional referral center for complex upper extremity trauma. Dr. Joshua Adkinson has been named Chief of Hand Surgery in the Division of Plastic Surgery at Indiana University. He started the first Pediatric Brachial Plexus Team in the State of Indiana. Dr. Matthew Brown established The Hand Clinic at Midland Plastic Surgery in Texas and became board certified by the American Board of Plastic Surgery. Dr. Brett Michelotti combined the Hand Surgery Service (plastics and orthopaedics) at the University of Wisconsin-Madison for patient care and resident education as well as developing their Lymphatic Surgery Program. Dr. Paymon Rahgozar has been an Assistant Professor at the University of California, San Francisco; his practice focuses on adult and pediatric/ congenital hand and reconstructive surgery. In 2017 Dr. Rahgozar’s paper that he co-authored with Dr. Chung was presented at the ASSH Annual Meeting and won the “ASSH Linscheid-Dobyns Excellence in Wrist Research Award”. Dr. Nathan Taylor continues to enjoy hand surgery in Michigan’s Upper Peninsula and our very own Drs. Jennifer Waljee and Erika Davis Sears continue as University of Michigan faculty. Joining us this fall is Drs. Sarah Sasor and Philip Ross. We welcome them to our hand surgery family and look forward to the exciting year ahead!
GRADUATING HAND FELLOWS Drs. Brian Kelley and Liz Qiu will complete their Hand Surgery Fellowship soon and will be greatly missed. It’s been an eventful and successful year both personally and academically for the fellowship duo. Dr. Kelley celebrated the birth of his daughter Maeve and is looking forward to joining an academic practice in Austin, Texas. Dr. Qiu is still evaluating potential job opportunities and ideally would like to choose a location that she and her family can enjoy together. We wish both of them a bright and successful future!
2018-2019 HAND FELLOWS
Sarah Sasor, MD
Indiana University School of Medicine
Phillip Ross, MD
UC Health - Cincinnati, OH
2019-2020 HAND FELLOWS
Elissa Davis, MD Loyola University
Rachel Hooper, MD University of Michigan
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“Working with the international scholars provides our team with an opportunity to learn from different cultural perspectives, giving us an insight into the nature of health care and medical practice in their respective countries. This collaboration also leverages resources from both sides, furthering our knowledge in the field of hand surgery on a more global scale.” ~M-CHOIR Team
INTERNATIONAL SCHOLARS UPDATES “I have studied and published a paper regarding validity and reliability of Japanese MHQ as a member of the Impairment Evaluation Committee, JSSH after I left U-M in 2008. Currently, I work as Chief Surgeon, Department of Orthopaedic Surgery at Hokkaido Saiseikai Otaru Hospital in Hokkaido, Japan. I aggressively perform arthroscopic surgery of the elbow as well as common hand surgery, and investigate risk factors of distal radius fracture in post-menopausal women.”
~Dr. Takashi Oda “Now I work at Siriraj Hospital in Bangkok, Thailand and continue as Associated Professor in my department. Most of my work is microsurgery and hand surgery. I initiated the project for the lymphedema treatment that is the biggest series in Thailand. I implemented all of my experience in Ann Arbor for medical education and hand surgery achievement.”
~Dr. Sirichai Kamnerdnakta “I became associate professor on April 2017, in the Dept. of Plastic Surgery in Nippon Medical School, Tokyo, Japan. I got married in 2014, and have two children, girl and boy, now.”
~Dr. Shimpei Ono 6
“I am working in the Department of Hand Surgery, Nagoya University as an associate professor. Fortunately I have many surgical cases about hand OA, hand tumor, and hand trauma. I remember Dr. Chung’s operations while treating patients. My current project is on developing a next generation small arthroscopy. I am also conducting a multi-center study for Dupuytren’s contracture about collagenase injection vs. fasciectomy. On the weekend I play tennis with my friends and go to a hot spring with my family. I hope all the alumni and current staff are doing well.”
upper extremity chapter for Grabb & Smith’s Plastic Surgery 8th edition will be submitted recently. I am grateful for my time with Dr. Chung’s research team and am so glad to continue learning from Dr. Chung.”
~Dr. Guang Yang
~Dr. Michiro Yamamoto “I am now working in Nagoya Ekisaikai Hospital in Nagoya city, Japan, as a hand surgeon, and I am now the medical director in the orthopaedic department at our hospital. In addition, I conducted several clinical studies regarding tendon injuries, and wrote some papers.”
~Dr. Yuki Fujihara
“I am faculty in the Department of Hand Surgery at the China-Japan Union Hospital of Jilin University in China. I studied with Dr. Chung as an international research scholar for one year. Although I came back to China in October 2014, my research under Dr. Chung keeps going on. I participated in Dr. Chung’s book Operative Techniques: Hand and Wrist Surgery 3rd edition. The compartment syndrome of the
INTERNATIONAL RESEARCH SCHOLAR Hidemasa Yoneda, MD, PhD came to work with the M-CHOIR group from Nagoya University in Japan, where he works as a hand surgeon. He has been with Michigan Medicine since last March. Dr. Yoneda is working on developing new implants and prostheses for fractures or degenerative diseases with several companies in Japan. Dr. Yoneda states that “The knowledge I had gained in the stay at University of Michigan, including Dr Chung’s surgeries, is useful for this development.” He is looking forward to providing the best surgeries with the implants he develops.
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Surgery of the Hand. From 2016, Dr. Kawamura has been working at Nara Medical University as an associate professor of Susumu Tamai Limb Trauma Center.
2018 AWARD RECIPIENT OF THE HAROLD E. KLEINERT TRAVELING FELLOWSHIP Dr. Kenji Kawamura was the first visiting international hand surgery scholar back in 2005. Since then, he has made strides in the field including his most recent recognition as the first recipient of the prestigious Harold E. Keinert Traveling Fellowship for 2018. There are certain luminaries in our specialty who we like our names to be associated with, whether it is the program we were trained or a named award we received. Harold Kleinert is such a giant in our field. The Kleinert Fellowship is an endowed traveling fellowship in honor of Dr. Kleinert and his trainees for an international star who will travel in the U.S. and visit the acclaimed Louisville Hand Center and a few other prestigious centers. This first recipient of this award the Kleinert Fellows selected is Dr. Kenji Kawamura. Dr. Kawamura graduated from Nara Medical University, Japan, in 1999 and started orthopaedic surgery fellowship. He had trained in the programs of hand surgery and microsurgery at Nara Medical University Hospital. In 2005, Dr. Kawamura visited the University of Michigan for six months as an international hand fellow of Dr. Kevin Chung’s. In 2010, he completed requirements to acquire a Qualified Hand Surgeon certificate by the Japanese Society for
Dr. Kawamura states that he is “Honored to be selected the first recipient of Harold E. Kleinert Traveling Fellowship Award in 2018. Dr. Harold E. Kleinert was a giant in the field of hand surgery. Every hand surgeon knows his name. He dedicated himself to the education of hand surgeons from around the world. In the past, several Japanese hand surgeons received training from Dr. Kleinert. Even now, many Japanese young hand surgeons are eager to learn in Louisville. I am very happy to have an opportunity of learning hand surgery at Kleinert Institute as a traveling fellow.” Dr. Kawamura recognizes that to have success in the field of hand surgery, it is sometimes important who you received training from. He received training of hand surgery from three special hand surgeons. One is Prof. Susumu Tamai who is a pioneer of microsurgery. The next one is Dr. Hiroshi Yajima who is the present president of Japanese Society for Surgery of the Hand. The last one is Dr. Kevin Chung. Dr. Kawamura reflects that he “Learned excellent operative skills from them. Especially, Dr. Chung taught me how to write a scientific paper and elegant conduct of hand surgical procedures. All of my experiences in Nara and Michigan have played an important role in promoting my academic position in Nara Medical University.” As part of the Kleinert Fellowship, Dr. Kawamura will visit three hand institutes including Washington University in St. Louis, University of Michigan, and Christine M. Kleinert Institute for Hand and Microsurgery in Louisville. He hopes to learn these educational programs, new ideas and skills of hand surgery from each institute. “Most importantly,” says Dr. Kawamura, “I want to make good friendships with people in each institute.”
VISITING INTERNATIONAL HAND SURGERY SCHOLARS 2005
Kenji Kawamura, MD Nara Medical University Japan 2006
Seongeon Kim, MD SeMyeong Christianity Hospital Pohang, Korea 2008
Takashi Oda, MD, PhD Asahikawa Kosei Hospital Japan 2009
Sandeep Jacob Sebastin, MD National University Hospital Singapore 2010
Pao-Yuan Lin, MD Kaohsiung Medical Center Taiwan 2012
Shimpei Ono, MD, PhD Nippon Medical School Japan 2013
Keming Wang, MD Peking Union Medical College China
Yirong Wang, MD Peking Union Medical College China 2014
Guang Yang, MD Jilin University China
Takanobu Nishizuka, MD Nagoya University Japan 2015
Takeshi Ogawa, MD, PhD Tsukuba University Japan 2017
Michiro Yamamoto, MD, PhD Nagoya University Japan
Yuki Fujihara, MD, PhD Nagoya University Japan
Nasa Fujihara, MD Nagoya University Japan
Taichi Saito, MD, PhD Okayama University Japan
Sirichai Kamnerdnakta, MD Siriraj Hospital Mahidol University Thailand 2018
Hidemasa Yoneda, MD, PhD Nagoya University Japan
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M-CHOIR ALUMNI HIGHLIGHTS
Dr. Ming-Huei Cheng and M-CHOIR members
M-CHOIR Michigan Center for Hand Outcome & Innovation Research It was an exciting year for M-CHOIR. We published 54 manuscripts in 18 journals, in addition to publishing four textbooks. Our team was also awarded seven grants. This year should be another productive year. We have already published seven manuscripts and have submitted the first two manuscripts containing data from WRIST. This spring we will welcome a new research assistant, Sharon Kim. Sharon has been a hardworking volunteer on our team for one year and after she graduates from the University of Michigan in April (with a BS in Neuroscience and Spanish) she will work with us full-time for two years, gaining both research and clinical skills. She will join Jacob Nasser, BS, who is beginning his second year as an M-CHOIR Research Assistant. We are sad, but proud, to say goodbye to Meghan Lark, BS, Helen Huetteman, BS and Jennifer Sterbenz, BS. Meghan left us in 2017. She published five manuscripts in her time with us and has assisted with two more since. This fall she will start her M2 year at the University of Toledo College of Medicine. Helen will be attending Oakland University William Beaumont School of Medicine this fall. While on our team, she published 11 manuscripts, one of which (The Desired Role of Health Care Providers in 8
Guiding Older Patients with Distal Radius Fractures: A Qualitative Analysis) was selected for the Journal of Hand Surgery’s monthly interview pod-cast. Jen, who published four manuscripts with us, will be moving to San Francisco to pursue a career as a pastry chef. If the treats she brought to the office are any indicator, we think she will be a success! We wish them all the best of luck! Finally, in 2018 we welcomed our first M-CHOIR baby! Catherine Lu and her husband welcomed a baby girl, Anna, on March 13, 2018.
Major projects FRANCHISE: Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness is a retrospective study evaluating traumatic digit amputation patients. We have recruited 331 participants (175 replantation and 156 revisions amputation) so far. Currently, we are performing preliminary analysis to compare several patient-reported, functional, and sensory outcomes in these participants. We intend to submit several manuscripts arising out of this study beginning this summer. WRIST: All participants have completed a 12-month follow-up assessment and we have begun data analysis. We have submitted two papers thus far and have several more in the works. We are excited to be sharing the results of our research after seven years of hard work!
Chelsea Harris, MD, MS – Dr. Harris graduated from the University of Vermont School of Medicine in 2014 and matched into General Surgery at the University of Maryland. After completing two clinical years in Maryland, Dr. Harris came to the University of Michigan to complete a T32 Fellowship with Dr. Chung in Health Services Research. Through this fellowship, Dr. Harris has earned a Master of Science in Health and Health Care Research and has conducted multiple studies using mixed methods and complex survey methodology to investigate how patients’ unique contexts and preference shape their preferences in hand surgery. In addition, Dr. Harris is also very active in scholarly and advocacy work to advance diversity, equity, and inclusion in medicine. Finally, as the Creative Director at Annals of Surgery, Dr. Harris has developed her skills as a leading expert in visual abstracts and research dissemination techniques. This summer, after completing her tenure as a research fellow she will return to the University of Maryland as a PGY-3. Research Assistants – This spring two alumni research assistants will be graduating from medical school. Lauren Franzblau will graduate from the University of Michigan Medical School with a distinction in Medical Education. While a student, she developed a new course in medical ethics. She has matched in Internal Medicine at the University of Texas Southwestern. Dr. Franzblau began volunteering with M-CHOIR when she was a freshman at Pioneer High School. Over the years she published 12 manuscripts. Evan McGlinn will graduate from Wayne State University School of Medicine; he has matched in Emergency Medicine at Western Michigan University. During his time with us Dr. McGlinn published nine manuscripts and one chapter. Medical Students – Michael Nolte and Peter Swiatek both had prolific tenures at M-CHOIR while students at the University of Michigan
Medical School. Dr. Nolte published six manuscripts, one of which (Effect of Policy Change on the Use of Long-Distance Transport and Follow-Up Care for Patients with Traumatic Finger Amputations) was presented at the 2016 Annual Meeting of the American Society for Surgery of the Hand. Dr. Nolte graduated in 2017 and this summer will begin his second year as an orthopaedic surgery resident at Rush University Medical Center. Dr. Swiatek published seven manuscripts, including one presented at the 2016 ASSH meeting (National Practice and Impact of Preoperative Electrodiagnostic Studies for Carpal Tunnel Syndrome) and one presented at the 2018 Annual Meeting of Plastic Surgery Research Council (Utilization of mammography prior to elective breast surgery: A national claim-based analysis). Dr. Swiatek graduated in 2018 and has matched in Orthopaedic Surgery at Northwestern University. He got married in May 2018.
M-CHOIR 2018 ASSH ANNUAL MEETING ACCEPTED ABSTRACTS 1. Title: Outcomes after revision amputation or replantation in FRANCHISE (Finger Replantation And Amputation Challenges in Assessing Impairment, Satisfaction and Effectiveness) Study Authors: Kevin C. Chung, MD, MS; Sunitha Malay, MPH; Melissa J. Shauver, MPH; Wang Lu; Lin Zhong, MPH; The FRANCHISE Group 2. Title: Finger Replantation Optimization Study (FRONT): Update on National Trends Authors: Hoyune Cho, MD; Lin Zhong, MD, MPH; Sandra V. Kotsis, MPH; Kevin C. Chung, MD, MS To be presented at Best Papers, Clinical Papers Session: 3. Title: Cost-Effectiveness Analysis of Humanitarian Hand Surgery Trips According to WHO-CHOICE Methods Authors: Xuan Qiu, MD, PhD; Jacob S. Nasser, BS; Gloria R. Sue, MD; James Chang, MD; Kevin C. Chung, MD, MS
M-CHOIR FACULTY AND STAFF Faculty: Kevin Chung, MD, MS, Charles B. G. de Nancrede Professor of Surgery; Adeyiza Momoh, MD, Associate Professor; Erika D. Sears, MD, MS, Assistant Professor; Jennifer Waljee, MD, MPH, MS, Associate Professor; Lu Wang, PhD, Associate Professor of Biostatistics Staff: Research Coordinators: Pat Burns, MPH; Sandra Kotsis, MPH; Sunitha Malay, MPH; Melissa Shauver, MPH; Lin Zhong, MD, MPH, Catherine Lu, MPH: Research Analysts: Kate Chang, MS; Research Assistants: Sharon Kim, BS; Jacob Nasser, BS, Helen Huetteman, BS; Jennifer Sterbenz, BS; Residents: Jessica Billig, MD; Rachel Hooper, MD; Alfred Yoon, MD; T32 Research Fellow: H. Esther Cho, MD; Undergraduate Volunteers: Julia Howard; Alex Kocheril; Shannon Wood Collaborators: Onur Basser, PhD, MS: Noelle E. Carlozzi, PhD: Hyungjin Myra Kim, ScD
DISTINGUISHED HAND SURGERY LECTURESHIPS First Annual Dean Louis Hand Surgery Lectureship
Dean S. Louis, MD - Dr. Louis completed his residency at the University of Michigan before heading to New York as the Carroll Hand Fellow at Columbia Presbyterian Hospital. In 1971, he returned to Michigan - this time to join the University faculty. During his 30 years at Michigan, he specialized in congenital hand problems and served as a past president of the American Society for Surgery of the Hand. Today, he is professor emeritus for the Department of Orthopaedic Surgery and a legacy for hand surgery in Michigan. We will continue to honor his career with an annual lectureship in hand surgery. Dr. Andrew Palmer was the first invited speaker in August 2017. Dr. Palmer received his medical degree from Upstate Medical Center in Syracuse, NY. He completed his General Surgery Internship and Orthopaedic Surgery Residency at University of Michigan Affiliated Hospitals. He has been the recipient of many awards and grants for his investigational work on diseases of the hand and is the author of numerous articles pertaining to a wide range of medical and surgical topics. Dr. Palmer is a past president of the American Society for Surgery of the Hand. Dr. Palmer joined OCHS as a consultant in orthopaedics of the upper extremity. 9
T32 FELLOWS Dr. Chelsea Harris came to the
Hoyune Esther Cho is an incoming
NIH T32 research fellow in health services and outcomes research in Plastic Surgery, starting in July 2018. Esther completed her second year of training in general surgery at University of Connecticut. Her interest in seeking a T32 grant stems from her desire to become an academic surgeon in the future. She states that she “Wanted to devote some time to learn and conduct clinical research projects [and an] NIH training grant was a perfect opportunity.” As a T32 fellow, Esther is looking forward to a “Hands-on experience in designing and leading various research projects with a multidisciplinary research team under Dr. Chung’s guidance.” In looking at the trajectory of her career, Esther believes that “This postdoctoral research fellowship will grant me the knowledge and skills needed to become an academic surgeon in the future, balancing academic and clinical aspects of surgery in my career.”
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University of Michigan to complete a T32 Fellowship with Dr. Chung in Health Services Research after completing two clinical years at the University of Maryland where she matched into General Surgery. Through this fellowship, Dr. Harris has earned a Master of Science in Health and Health Care Research and has conducted multiple studies using mixed methods and complex survey methodology to investigate how patients’ unique contexts and preference shape their preferences in hand surgery. Dr. Harris states she “Wanted to advance my scholarly training at one of the premier research institutions in the country and to examine questions that were immediately relevant to my clinical practice and patients’ lived experience. Through this opportunity I have gained concrete skills in research design, analytic techniques, manuscript preparation, and grantsmanship.” In addition, Dr. Harris is also very active in scholarly and advocacy work to advance diversity, equity, and inclusion in medicine. Finally, as the creative director at Annals of Surgery Dr. Harris has developed her skills as a leading expert in visual abstracts and research dissemination techniques. Dr. Harris reflects that her research experience “Has been largely built on one another so it is difficult to pick one that is most meaningful, but one of the biggest endeavors I undertook was to submit an R21 research proposal examining how to better measure physicians’ daily discrimination exposure.”
This spring, after completing her tenure as a research fellow she will return to the University of Maryland as a PGY-3. She is “looking forward to applying the analytic techniques I have learned during this fellowship to emerging challenges in surgery.” Best wishes, Chelsea!
RECOGNITION FROM THE U.S. SURGEON GENERAL
Dr. Jennifer Waljee was recognized on Twitter by the U.S. Surgeon General for her efforts on organized statewide drug take-back events and publishing a guide to help health institutions partner with law enforcement agencies. Keep up the good work Dr. Waljee!
ORTHOPAEDIC SURGERY Dr. Kagan Ozer organized the first Dean S. Louis Day and invited Dr. Andrew Palmer as a guest speaker. It was a day of celebration of hand surgery at the University of Michigan, honoring the lifelong achievements of Dean S. Louis. Dr. Ozer’s international fellow, Dr. Emre Gok, won a research grant from the American Society for Surgery of the Hand to study ex-situ limb perfusion in rats. Dr. Ozer has published multiple articles on ex-situ limb perfusion in different animal models. They are also in the process of applying for additional funding from the Department of Defense, the National Institute of Biomedical Imaging and Bioengineering and the National Heart, Lung, and Blood Institute. Funding will support studies on the physiology of amputated limbs ex-situ, which will help the development of a strategy to prolong limb survival after amputation and ultimately improve the success of replantation. The microsurgery training course under the directorship of Dr. Ozer has trained multiple trainees this year including hand fellow, Dr. Liz Qiu, and orthopaedic residents Drs. Mark Morris, Andy Zhu, and Rajbir Hundal. The participants had a great experience working with live animals to learn and improve their microsurgical skills. Dr. Jeff Lawton continued to provide excellent care to patients of all ages. His interest in sports injuries is reflected in the many articles he published on sports-related hand and upper extremity conditions. Dr. Lawton and one of our current fellows, Dr. Brian Kelley, also submitted a grant to Arthrex to study the internal brace versus pin fixation for thumb metacarpophalangeal joint ulnar collateral ligament injuries.
ASSH TRAVELING FELLOWS As one of a dozen selected visiting sites for the ASSH International Traveling Fellows, the Michigan Medicine Comprehensive Hand Center welcomed Drs. Mauricio Maia (Brazil), Jemma Rooker (UK), and Jingheng Wu (China) in August 2017 and Gernot Schmidle (Austria), Kunihiro Oka (Japan), TakehikoTakagi (Japan), and Eren Cansu (Turkey) in September 2017. During their visit, they observed hand surgeries at our ambulatory surgical center and clinical encounters at our outpatient facility. The traveling fellows interacted with the Michigan hand surgery faculty, residents and fellows, and engaged in deep conversations about hand conditions, current treatments, and the Michigan experience. They also delivered presentations on their research and training experiences. This program from the ASSH promotes exchange of experiences and ideas in hand surgery between the United States and the rest of the world. Michigan Medicine Comprehensive Hand Center was selected in recognition of its contribution to the hand surgery community for excellence in patient care, research, and education.
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ASSH PLASTIC SURGERY VISITING PROFESSOR PROGRAM
Resident, Rachel Hooper, MD and Erika Sears, MD, MS, attending The Society of Black Academic Surgeons Annual Conference.
GRANT NEWS
Congratulations to Dr. Erika Sears who was awarded a VA Career Development Award for “Assessing Treatment Delay and Resource Use to Improve Value of Pre-Surgical Care.� For veterans receiving surgical care, quality improvement efforts need to focus not only on the period after surgery, but also must consider the care provided before surgery. This project will examine the differences in carpal tunnel syndrome-related care across VA medical centers during the time between diagnosis and surgery, including differences in numbers of visits and length of time prior to surgery. These findings will guide the development of organizational changes and lay the groundwork to improve coordination, access, and quality of care prior to surgery for other surgical problems. (Mentors: Eve Kerr, Rod Hayward, Sarah Krein, Kevin Chung) 12
Dr. Steven Haase was selected to participate in the 2016-2017 Plastic Surgery Visiting Professor Program through the American Society for Surgery of the Hand (ASSH). This program supports two participants each year to visit several sites around the country, with the goal of fostering interest in hand surgery amongst plastic surgery residents. Recipients of this award are selected by the ASSH Resident Education Committee. The other participant for the 2016-17 year was another Michigan Medicine Plastic Surgery Program alumni, Dr. Doug Sammer, who is now Chief of Hand Surgery at UT Southwestern. Go Blue! Dr. Haase visited the University of Louisville, University of Miami, and University of Utah during his travels. Activities on these trips included the usual visiting professorship items: grand rounds presentations, didactic lectures, journal club, complex case discussions, and cadaver dissection labs.
HAND CENTER PLANNING The new space for the Michigan Medicine Comprehensive Hand Center (MMCHC) is in early planning stages. However, we have entered a new phase of increased and more frequent efforts in terms of monthly meetings with the planning committee and the architectural team leading the process. The MMCHC space will be part of a new East Medical Campus (EMC) east of the East Ann Arbor Surgery Center. The primary service lines for phase one of EMC will include the Comprehensive Musculoskeletal Center, Dermatology and Otolaryngology. The anticipated completion date is as early as 2021-2022. Our team is currently discussing data, determining projections, and finding adjacencies among the teams that will have space at EMC. Discussions include available procedural space, the potential for walk-in acute/urgent care within sub-specialties, and the possibility of surgical operating space. A lot will be determined over the next six months that will set the foundation for how the physical space will look, function, and in what capacities it will service patients. What we do know is that this space will ultimately take our virtual hand center and create a physical space for orthopaedic and plastic surgery trained hand surgeons and clinic team members. We can look forward to being united under one roof.
ANNUAL VISITING PROFESSOR LECTURE We have now offered our eighth annual Visiting Professor Lectureship in Hand Surgery. Originally started within the Section of Plastic Surgery, the lectureship has included premiere plastic and orthopaedic surgeons from across hand surgery. Our past lecturers are among the nation’s most distinguished professors, including Drs. Peter S. Stern, W. P. Andrew Lee, Richard A. Berger, Nicholas B. Vedder, L. Scott Levin, James Chang, James P. Higgins, Allen T. Bishop, Richard H. Gelberman and Brent Graham. This year’s distinguished Visiting Professor of Hand Surgery was Dr. Michelle Carlson, Professor of Clinical Orthopaedic at Weill Cornell Medical College, Attending Orthopaedic Surgeon and Director Research of the Hand Fellowship at the Hospital for Special Surgery and Founder of the Children and Adolescent Hand and Arm (CHArm) Center in New York, NY.
2018 VISITING PROFESSOR PROGRAM Our faculty, fellows, and residents were excited to learn from our Annual Hand Visiting Professor Program, which was held May 4-5, 2018. The Michigan Medicine Comprehensive Hand Center welcomed Dr. Michelle G. Carlson as this year’s visiting professor. Dr. Carlson specializes in treating sports-related hand injuries and fractures, and pediatric hand conditions. Dr. Carlson’s research interests include the treatment of athletic injuries of the hand and wrist, scaphoid fractures and nonunions, scapholunate ligament injuries, and upper extremity issues in patients with cerebral palsy. Dr. Carlson serves as an independent second opinion physician for the NBA and NBPA, and as the consulting hand surgeon for several professional sports teams, including the New York Knicks, Brooklyn Nets, New York Mets, and New York Liberty, as well as St. Johns University and Iona College. Dr. Carlson has also been an active member on the Board of American Society for Surgery of the Hand, serving six years on the council, three of which as treasurer from 2014-2017. We were grateful to learn from Dr. Carlson’s extensive experience treating scaphoid fractures and nonunion, as well as her approach to managing hand and wrist injuries in athletes. Lastly, our residents and fellows were able to highlight the clinical and research expertise that we have at Michigan Medicine as well. Through clinical case and research presentations, we were able to exchange ideas with one another and with Dr. Carlson as a leader in hand surgery. We look forward to planning another engaging educational program in 2019. 13
motive or industrial injuries. None of the local surgeons could afford loupes for magnification. There were no fiberglass casts or pre-packaged sterile dressings. There were only Vicryl and nylon sutures in limited sizes. The “K-wire driver,” and I use the term loosely, was a common, household drill.
Read Dr. Kelley’s full article in the June issue of PSN
MISSION TRIPS Vietnam As part of the hand fellowship experience at the University of Michigan, along with support from ReSurge International, Drs. Kevin Chung and Brian Kelley had the opportunity to complete an educational service trip to Hanoi, Vietnam. They were invited by Dr. James Chang, Medical Director for ReSurge, formerly InterPlast. The trip was organized by Dr. Nguyen Quang Trung, Medical Director at Vien Chinh Hinh Hospital. The hospital is an openair building with up to 10 beds per room, with approximately 100 beds in total. There were two operating rooms that were well maintained, but certainly under-supplied. Specifically, the request was to receive educational support for congenital hand patients who were under-treated, especially in the northern mountainous regions of Vietnam. These rank amongst the most under-served areas of the world according to the World Health Organization. At this hospital, there were no surgeons with 14
dedicated hand training. Dr. Trung and his colleagues are excellent surgeons specializing in a variety of orthopaedic conditions but lacked advanced training in these complex hand operations. During the trip, we saw 25 patients and 11 were selected for surgery during the four-day visit. Windblown hand, radial deficiency, clasped or duplicated thumbs, camptodactyly, Apert syndrome, and elbow arthrogryposis were just some of the disorders seen. The children were pre-operatively screened, and the care was excellent - not surprising given our impression of the local team. The hospital and the Vietnam Health Ministry donated the hospital time and surgical care of these patients in cooperation with some assistance from ReSurg - incredibly, this was estimated at only $200-400 per patient, including a week of admission to the hospital. Performing surgery in a poor, urban Vietnamese hospital is, as expected, a completely different experience. There were no fine instruments, this being an orthopaedic hospital that typically treats auto-
Despite these limitations, we were impressed with the collaborative interactions amongst the medical team to keep the operations running smoothly. Room turnover was careful and efficient. Nurses made plaster casts between surgeries in the anteroom while the room was cleaned and the next patient readied. The casts were meticulously inspected by the surgeons between cases, and there was no hesitation if they needed to be adjusted or remade. Gowns were washed and hung to be reused again the next day. The two drills were bathed in disinfectant between operations and cleaned. The unused wires were sterilized to be available again. It was amazing and humbling for me to see healthcare delivered on a entirely different scale. The facets of this care are hard to reconcile when compared to Western medical expectations. It is difficult to imagine acceptance of a family-centered care system in the U.S., where one’s family was also expected to be your nursing staff. Amazing, though, this was incredibly effective in Vietnam and the buy-in from these families was high. Drs. Chung and Kelley are planning to return to Hanoi to continue this emerging relationship. - Brian Kelley, MD
Bolivia
Jeanne Riggs, OTRL/CHT completed her first medical mission trip through the ASSH Touching Hands Project in partnership with ReSurge International. She spent two weeks (May 13-27, 2017) in La Paz, Bolivia as part of an 11-member team of hand surgeons, anesthesiologists, nurses, interpreters/ coordinators and one pediatrician. The mission to Bolivia has been an ongoing one and done in coordination with a local hand surgeon, the only local hand surgeon in the area. He arranged for patients to come to the first clinic day that Monday and had pre-screened the patients. Patients were seen in order of arrival and evaluated by hand surgeons. Once vitals were taken by nursing, patients were evaluated by the pediatrician, and an anesthesiologist. Finally a chart was made, photos were taken, and families were told that they would get a call the night before if they were to be scheduled for surgery over the next 2 weeks. Clinic ran into the early evening and it took 5 ½ hours to set up the OR (circulating nurse and anesthesiologist).
With only one OR, the hand surgeons performed 22 pediatric cases and 10 adult cases over eight OR days. Diagnoses included congenital anomalies, Dupuytren’s, burn scar, osteochondroma, joint contracture, arthritis, nerve palsy, and tendon adhesions.
In hand therapy, Jeanne spent time training three local therapists, replacing orthoses for patients treated previously, treating post-op patients, discharge planning, and providing patient education. The team enjoyed some fun together outside of the hospital during a free weekend, which included biking, shopping, dining, and sightseeing. It was a very positive experience and her next trip is scheduled for San Pedro Sula, Honduras with the Touching Hands Project!
Taiwan As part of their fellowship training, Drs. Paymon Raghozar (2017) and Liz Qiu (2018) both visited Chang Gung Memorial Hospital in Linkou, Taiwan. During this one-week visit, they observed in the operating room and outpatient clinic, and learned from some of the world’s finest microsurgeons. They also interacted with the faculty, residents, and fellows at Chang Gung, including international fellows from all over the world. They each delivered two talks to the faculty and trainees during morning conferences at Chang Gung, including one on a hand condition, and one on research methodology or surgical education. Paymon spoke about proximal interphalangeal joint fracture dislocations, and how to create a research idea. Liz discussed about Kienbock disease, and surgical education in America. They both used their own experiences in fellowship as examples. During their preparation and delivery of these talks, they reflected on their own learning and growth as young surgeons on their paths to a fulfilling future career in hand surgery.
BOOK RELEASES Over the past two years, Dr. Chung and his associate editors embarked on an ambitious journey to provide a three-volume encyclopedia textbook on all the plastic surgery procedures, including a volume on hand surgery. This superbly illustrated, authoritative guidance provides operative techniques along with a thorough understanding of how to select the best procedure, how to avoid complications, and what outcomes to expect. Easy to follow, up to date, and highly visual, this step-by-step reference covers nearly all operations in current use in plastic surgery, and is ideal for residents and physicians in daily practice. The book comprehensively covers all areas of plastic surgery including facial aesthetic, breast, hand, trunk reconstruction and body contouring, head and neck reconstruction, craniofacial trauma and reconstruction, lower limb reconstruction, and pediatric plastic surgery. Dr. Chung and his team also published Hand and Wrist Surgery, Third Edition, which is one of the most popular hand surgery textbooks in the world and is used as the standard textbook in many institutions for teaching hand surgery principles. This book covers a full review of hand indications and techniques, patient scenarios, and upper extremity disorders. 15
2017 ASSH MEETING CONTRIBUTIONS Michigan Group Everything you need to know about proximal interphalangeal joint trauma Chair: Dr. Ozer; Speakers: Drs. Ozer, Haase, Waljee, Sears, Lien, and Lawton Dr. Jennifer Waljee 35th Adrian E Flatt Resident & Fellows Conference speaker and upcoming Chair Research Methods: Stepwise approach to answering complex questions Practical Tips to Keep Your Practice Compliant with Quality/Value Based Payments: Quality and Practice Improvement Requirements and Tips AFSH: Your Dollars At Work Pain Prescribing Patterns and programs to improve care PQRS and the orthopaedic preferred specialty measurement set (OPS): What are they and how to implement Dr. Jeffrey Lawton Athletic Injuries in the upper extremity: treatment and return to play Dr. Kagan Ozer International Wrist Investigators Workshop Speaker Dr. Paymon Rahgozar Best Papers -- Comparative Analysis of Resource Utilization between proximal row carpectomy and partial wrist fusion: A population study Helen Huetteman Utilization and associated spending for anesthesia services during ambulatory hand surgery. 9/28/18 Dr. Paymon Rahgozar’s above paper selected for the Linscheid-Dobyns Excellence in Wrist Research Award 1/5/18 Dr. Kenji Kawamura selected as the 2018 AFSH Harold E. Kleinert Fellowship award recipient
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DISTINGUISHED CLINICIAN AWARD On November 4, 2017, Carole Dodge was awarded the “Distinguished Clinician” award from ARHP (Association of Rheumatology Health Professionals) in San Diego. She has been a member of ARHP since 1991 and has held many positions within the organization. Carole has been an occupational therapist since 1980, and began practicing in rheumatology at the University of Cincinnati in 1991. When she moved to Michigan in 1996, the then director of rheumatology wrote her a letter of introduction which helped her become established at Michigan Medicine with rheumatolgy (Dr. David Fox), with hand therapy (Dr. Chung), and with PM&R (Dr. Andrew Haig). Carole received her CHT (certified hand credential) in 2007. She has had the opportunity during her career at Michigan to travel and teach on two occasions in Macedonia at the University of Skopje with two of our rheumatologists. This resulted from her ongoing building of relationships with physicians, and her involvement in the ARHP. She credits these relationships with the different departments to the ongoing professional development opportunities she has had and the growth in hand therapy referrals the program has seen. It has been a joint effort with departments to grow and develop the program for both patients and staff. Carole reflects back on how she became an occupational therapist in the first place. She recalls that at the age of 16 while volunteering in a physical medicine department in a local hospital in NJ, she walked into the OT clinic saw how they were utilizing activities to help patients reach their goals and she knew then that it was exactly what she wanted to do. She plans on working as an OT until she retires and feels very fortunate that she found her true calling so early.
Carole Dodge, OTR/L, CHT Occupational Therapy Supervisor and Occupational Therapist Clinical Specialist
A WARM WELCOME
Erika Arndt, MPA Project Manager, Section of Plastic Surgery, Comprehensive Hand Center
Our new project manager, Erika Arndt, MPA has joined our Michigan Medicine Comprehensive Hand Center (MMCHC) as of January 2018. She is a project manager for MMCHC 50% and Plastic Surgery 50%. Main job duties include: helping with developing our 3-year strategic plan; working with the East Medical Campus planning committee for the buildout of the new MMCHC space; and working across the Michigan Medicine offices for the growth and promotion of our services, such as working with our brand manager, physician liaison, and development officer. Erika has a master’s degree in health care administration and completed her post-graduate administrative fellowship with Beaumont Health, working with executive hospital and physician leadership. She went on to become a cardiology manager for almost three years at Beaumont Hospital where she worked on the growth of outpatient cardiology clinics and the management of clinic operations and inpatient/outpatient testing services. She and her husband moved to the Ann Arbor area to put down roots near family and are enjoying all that the city and area have to offer.
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GIVE THEM A HAND Everyone has a hand in making the clinics flow efficiently, effectively and providing excellence in patient care. Take a look at our Physician Assistant (PA) Teams and Hand Therapy Teams.
SOUTH MAIN PA TEAM
Alisa Stager, Mikeal Wdowiak, Cecilia Fagan
DOMINO’S FARMS PA TEAM
Amy Holland, Kristen Gittins
“This has been a year of great
“The DF team welcomed the
growth for our team. We have en-
newest member to the team,
joyed all the challenges and look
Kristen Gittins’ son, Simon Isaac,
forward to next year.”
born May 24th. Congratulations,
~Cecilia Fagan, PA-C
Kristen!” ~Amy Holland, PA-C
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Our hand therapists had a great year at each of our locations - Domino’s Farms, South Main, and Burlington. DOMINO’S FARMS HAND THERAPY
Jasmine Krishnan, Jeanne Riggs, Cheryl Showerman, Jen Burrows
BURLINGTON HAND THERAPY
Carole Dodge, Lexie Muir, Linda Miner, Colleen Coughlin. Not pictured: Nancy Cox, Terry Conlin, Julianne Shustock.
SOUTH MAIN HAND THERAPY
Kurt Hiser, Mary Barber, Heather Nicholas
“The occupational therapy team
“This year at the Burlington UE /
“We have worked hard in the clinic
(in the Plastic Surgery Clinic)
Hand Therapy Clinic we finally re-
to make it an enjoyable space for
celebrated several recent accom-
ceived a low level laser unit. We
our patients and team members.
plishments: Jasmine received her
are finding this additional modality
Our hope is that patients will have
Master in Health Services Adminis-
extremely helpful for our entire pa-
a positive experience while they
tration (MHSA); Jeanne completed
tient population (trauma, cumula-
are here, and if we are lucky even
her second medical mission trip,
tive trauma, CRPS, and arthritis) to
have a few laughs. We added
thanks to the Touching Hands
enhance tissue repair and reduce
blue sky light covers and a Blue-
Project, to San Pedro Sula, Hon-
edema, pain, and inflammation.
tooth speaker, and give patients a
duras; and Cheryl and Jen are
We think of it as our ‘Magic Bullet.’ ”
chance to choose the music while
working hard planning the Michi-
~Linda Miner, OTRL, CHT
they are here. Feedback from
gan Medicine Hand Symposium,
our patients includes ‘This seems
a conference for hand therapists
like such a happy place to work. I
scheduled for Spring 2019.”
enjoy coming here to see you all!’ ”
~Jeanne Riggs, OTRL,CHT
~Heather Nicholas, OT, CHT 19
If you would like to MAKE A DONATION to our wonderful program, please contact Matthew Douponce at mdoupo@med.umich.edu or 734-763-5392 Š 2018 Regents of the University of Michigan
Graphic Design: Jennifer Curley; Editors: Erika Arndt, Lynne Jandasek, Liz Qiu, Melissa Shauver, Debbie Newton
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