YEAR IN REVIEW
2018-2019 COMPREHENSIVE HAND CENTER
INTRODUCTION 3 HAND FELLOWSHIP PROGRAM 4-5 MISSION TRIP 6-7 INTERNATIONAL VISITING FELLOWS 7-8 HAROLD E. KLEINERT TRAVELING FELLOWSHIP 10 - 11 ASSH MEETING CONTRIBUTIONS & TRAVELING FELLOWS 12 -13 VISITING PROFESSOR PROGRAM 14 - 15 M-CHOIR 16 - 17 M-OPEN 18 ANNOUNCEMENTS 19 BOOK RELEASES 20 ORTHOPAEDIC SURGERY 21 OCCUPATIONAL THERAPY 22 - 23
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 Program Director, University of Michigan Hand Fellowship Medical Director, Wound Care Program and Comprehensive Wound Care Clinic
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 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
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Dear Friends, I am pleased to present a most informative newsletter to you. This past year has been highly productive clinically, academically, and educationally for our hand surgery program. Our clinical enterprise is thriving with expansion into outlying facilities in Brighton and Northville located in the suburbs of Detroit. Furthermore, we are planning to collaborate with our affiliate health systems in Mid-Michigan and West Michigan. These outreach efforts further consolidate the preeminent reputation of our hand program. The Michigan Center for Hand Outcomes and Innovation Research (M-CHOIR), the research arm of the hand program, had a very successful year publishing over 50 papers in high profile journals. M-CHOIR has received continuous National Institutes of Health funding for close to 20 years. Recently, our researchers received a NIH U-01 grant to fund the Surgery of the Ulnar Nerve (SUN) study. This is a multicenter clinical trial that includes 10 institutions across the US. We are proud of our faculty members who contributed tirelessly to our academic effort, as well as the dedication of our trainees who place us in the upper echelon of hand surgery programs in the world. We continue to host international scholars and senior hand surgeons who wish to partner with us in academic and educational activities. Our Comprehensive Hand Center is in the planning stage of the East Ann Arbor campus expansion. Over the next few years, we envision a facility that is dedicated to the care of anyone with hand and upper extremity conditions in the state of Michigan and beyond. On a somber note, Dr. Dean Louis—our senior hand surgeon—has passed away. His illustrious career at the University of Michigan is felt every day. His legacy of educational excellence is perpetuated by the Dean Louis lectureship that invites a senior hand surgeon who ascribes to Dr. Louis’ commitment to teaching and mentorship. We continue to thrive in the areas of academic research, training, and patient care. With your support and guidance, the University of Michigan Comprehensive Hand Center will continue to embrace its reputation as leaders and best in the field of hand surgery. Sincerely,
Kevin C. Chung, MD, MS Chief of Hand Surgery, Michigan Medicine University of Michigan Comprehensive Hand Center
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2019 GRADUATING HAND FELLOWS
GRADUATING ORTHOPAEDIC RESIDENT
Dr. George Cibulas
Drs. Phillip Ross and Sarah Sasor completed the Hand Surgery Fellowship and will be greatly missed. It has been a productive year for the fellowship duo. Dr. Ross will be heading back to the University of Cincinnati and Dr. Sasor accepted a position at the Medical College of Wisconsin. We wish both of them a bright and successful future! Dr. Ross had the privilege of traveling to Vietnam to take care of children alongside Dr. Chung. Be sure to read his full article on pages 14-15.
Congratulations to our orthopaedic resident, George Cibulas MD, who will be going to Columbia Orthopaedics, formerly the New York Orthopaedic Hospital, at New York Presbyterian-Columbia University Irving Medical Center to do a hand fellowship! Columbia Orthopaedics is one of the oldest one-year fellowships dedicated to hand surgery in the United States. We wish him the best in his hand surgery fellowship and career.
HAND SURGERY FELLOWSHIP The University of Michigan Hand Surgery Fellowship enters its 10th year in 2019! We were very excited to match two outstanding candidates for hand surgery training in 2019-2020: Dr. Rachel Hooper from our own plastic surgery res4
idency training program, and Dr. Elissa Davis from the Orthopedic Residency Program at Loyola University Medical Center. In 2018, Dr. Steven Haase transitioned from Associate Program Director into the role of Program Director, taking over for Dr. Kevin Chung, who had led the program since its inception in 2010. The fellowship continues to grow in popularity, attracting a record number of applications this year. Drs. Chung and Haase attribute the program’s success to its combined approach to hand surgery education. Though our teaching faculty is composed of both orthopedic and plastic surgeons, we pride ourselves on all being “hand surgeons”. “Our
fellowship works to break down the artificial barriers between these two disciplines by having the fellows rotate equally on both services throughout the year, allowing our fellows an unparalleled experience in terms of case variety and practice styles. This approach, along with strong didactic instruction and mentoring in research, makes our fellowship really stand out amongst other hand surgery training programs!”
Year 2011 Nathan S. Taylor, MD Advanced Center for Orthopedics
Jennifer F. Waljee, MD, MPH, MS University of Michigan
Year 2013 Kate W. Nellans, MD, MPH Hofstra Northwell School of Medicine
Year 2014 Joshua M. Adkinson, MD University of Indiana
Year 2015 Erika Davis Sears, MD, MS University of Michigan
Year 2016 Matthew S. Brown, MD Midland Plastic Surgery Center
Year 2016 Brett Michelotti, MD University of Wisconsin
Year 2017 Kate Elzinga, MD University of Calgary
Year 2017 Paymon Rahgozar, MD University of California, San Francisco
Year 2018 Xuan (Elizabeth) Qiu, MD Zucker School of Medicine
Year 2018 Brian Kelley, MD Seton Ascension Healthcare
Year 2019 Phillip Ross, MD University of Cincinnati
Year 2019 Sarah Sasor, MD Medical College of Wisconsin
Year 2020 Rachel Hooper, MD
Year 2020 Elissa Davis, MD
Year 2012
Steven C. Haase, MD Program Director, University of Michigan Hand Surgery Fellowship 5
VIETNAM MISSION TRIP DR. PHIL ROSS, HAND FELLOW
and Trung planned a return visit to follow up on patients and continue local surgeon education.
As a hand surgery fellow at the University of Michigan, I had an incredible opportunity to participate in a visiting educator trip to Hanoi, Vietnam. International surgical trips appeal to new and experienced surgeons alike on many levels. For those who can remember that far back, most of us mentioned helping others on our medical school applications or interviews, and serving abroad feels like a perfect way to further fulfill that commitment to altruism. Furthermore, we get to travel to exotic locations as more than a tourist. The cross-cultural exchanges that occur while working with the local teams are both deep and rewarding. Our trip to Hanoi was supported by ReSurge International and was the product of collaboration between Professor of Plastic Surgery Kevin Chung, MD, MS, and Nguyen Quang Trung, MD, the Medical Director at Vien Chinh Hinh Hospital. Drs. Chung and Trung built a strong professional relationship during a previous ReSurge visiting educator trip in May 2018. Subsequently, Drs. Chung 6
I had few expectations entering the trip, but by the end of the week, I had a new appreciation for health care in Vietnam. Of the many obstacles patients face to obtaining quality health care, lack of resources is paramount. This was not a surprise, and the local teams do an amazing job providing care with what they have. For the purpose of our trip, however, the language difference proved to be the highest barrier to our educational mission. Even armed with the Google Translate app on our phones, we were minimally independent. Our attempts to pronounce “please,” “thank you,” and “pho” (Vietnamese soup), were generally met with blank stares. Astonishingly, with some rudimentary translation and the help of our coordinator/translator Hong, Dr. Chung and I were able to communicate with the patients, nurses, and doctors, and many themes emerged that transcended language and cultural differences. According to our local trip organizer, Dr. Trung, there are very few dedicated hand surgeons in Vietnam. He is a general orthopedic surgeon who operates on the upper and lower extremities. He asked us to visit for the specific purpose to learn more about pediatric hand surgery. Dr. Trung had selected certain patients to time their visits with our arrival. In total we saw 32 children with congenital and traumatic
hand problems. The Vien Chinh Hinh Hospital team is very adept. The problems they reserved for us were remarkable and challenging. Some of the incredible pathology included radial longitudinal deficiencies, absent thumbs, windblown hand, syndactyly, complex burn contractures, tendon and nerve injuries, and cleft hand, to name a few. Most patients came to see us because their home doctor did not have anything more to offer. They were instructed to come see the dedicated foreign hand surgeon. Many had seen Dr. Trung personally or one of his colleagues. While a few patients were from Hanoi, the majority traveled in from surrounding provinces, usually about 2-3 hour drives. The common themes among the patients were a desire to get well and an exuberance for life. When we rounded on the surgical patients each morning, it was clear that they wanted to get back to playing. Each communal room contained 3-4 patients and they were uniformly loud with the children moving between each other’s beds while the parents watched.
Severe burn contracture seen in Hanoi
Even though I couldn’t understand a word being said, I saw many of the same traits which I see in pediatric patients back home. One shy 11
year-old boy hid behind his mother every time we came to check on his opponensplasty. One patient with a severe burn to the back of his hand loved to make silly faces at me and pose for pictures. Another 4 year-old could not keep his hands off his mobile phone video games, despite our best efforts to limit him with bandages for his syndactyly release. A 5 year-old boy who underwent wrist centralization was crying each morning that we saw him. We assumed his surgical pain was severe, until his mother clarified that he had been content until he received a shot each morning before we walked in. The distaste for needles is indeed universal! The children ranged in age from 14 months to 19 years. During the week I was able to ask some of the older ones about their impressions of care. A 19 year-old young woman with a thumb contracture, related how impressed she was that Dr. Chung and I came to talk with her each morning at the hospital. The boy with the opponensplasty confessed that he was very nervous before surgery, but as the process played out, he was becoming more and more comfortable. One 9 yearold girl impressed me with her insight and ambition. She was born with one “windswept hand” with finger flexion and webspace contractures, and proudly told us that she wants to become a doctor so she “can help other children with similar hands”. Just like back home in the United States, the families
Concomitant cleft hand and contralateral syndactyly in Hanoi”
we met in Hanoi would do anything they could for their children. Aside from making 2-3 hour drives from their hometowns, they made numerous other sacrifices to see us. One mother told us that she had marked the week on her calendar over 6 months in advance, while others made last minute work changes to be there. The father of a 4 year-old with a dorsal hand burn contracture not only brought his son from a province three hours away, but he also told his cousin, who then brought his 8 yearold daughter for syndactyly release. This family was from the Nung ethnic minority. To get back to their farms quickly, they had arranged for their son to stay with his grandparents in Hanoi for three weeks to be available for post-operative care.
A 4-year old boy poses for postop with his favorite toy.
When interviewed about their impressions of foreign surgeons coming to Hanoi, parents generally had positive things to say. Several expressed gratitude for free surgery and did not mind if it came from a Vietnamese or American doctor. At least two mothers and a father had
been told that their children needed surgeries, which were beyond the scope of a general orthopedist, and could only be done by foreigners. Another common theme was the efficiency of the surgical trip. A couple mothers appreciated that their son or daughter was evaluated on Monday and in the operating room a day or two later. Over the course of the week, the small community that developed on the wards between families was remarkable. The girl with a windswept hand followed us on rounds to each room, watching our evaluations and checking in herself on all the other patients. I spotted one mother mopping the floors around her son’s and neighbor’s beds. Another mother told me through Hong that she planned to keep an eye out for other children with hand problems after she returned to her hometown and refer them to Vien Chinh Hinh. At the end of the trip I had the opportunity to sit down with a few nurses to gather their perspective on the American visiting educators. They were grateful for our presence. The head OR nurse told me how the patients were all poor by Hanoi standards. This was their chance for “very good successful surgery.” Another nurse appreciated our “friendliness to patients”. The nurse was happy to help the pediatric patients “have a chance to feel normal like the other children.” All of the nurses I spoke with expressed a responsibility towards those less fortunate. Their care for the patients was evident in their hard work. Because stretchers
were scarce, the staff transported the younger patients to and from the operating table in their arms like they were carrying a child of their own. The head nurse also told me that prior to our arrival, they had collected food donations to supply some lunches to the patients as this hospital has no cafeteria or food service. Others gave toys or fans for the rooms
Phillip Ross with a future pediatric hand surgeon.
None of the clinic or OR staff spoke any English, yet we were able to work together rather smoothly. They were very fast to pick up our clinic flow. Hand gestures for scalpel, scissors, and suture, seem to translate into any language. Even Dr. Chung’s wringing-fist was quickly recognized as the desire for a “dry-moist” sponge. Despite our motions and two functioning translators, some aspects of surgery were still lost between care-givers. For example, at least one cast needed to be changed each morning for being too tight or immobilizing joints. For the local doctors joining us, the week was intended to provide practical hands-on experience with uncommon procedures. They expected to
learn updated techniques and gain experience by watching. Five Vietnamese surgeons, in addition to Dr. Trung, operated with us. One surgeon normally works with Dr. Trung at the base hospital, but the rest were from areas outside Hanoi. Two traveled two hours south from the town of Thai Nguyen for the week. All of them had heard of our educational mission through personal connection, mostly Dr. Trung himself. The doctors from Thai Nguyen had worked with him at a previous hospital years ago and maintained a professional relationship. Our hosts encouraged us as visiting educators to learn as much as possible about the patient population so we could discuss the most relevant conditions and surgeries. To that end, ongoing relationships like the one between Dr. Chung and Dr. Trung, become even more valuable. By the second day of surgery, learning was more hands on. Dr. Chung and I were assisting more than leading. At the end of the week, Dr. Quang from Thai Nguyen, told me over lunch that “now for simple cases [he feels] very confident to do [the surgery] properly.” My week in Hanoi demonstrated many aspects of our profession that cross cultures. This includes education, care, and gratitude. This trip will certainly not be the last mission work in my career. The challenge moving forward will be to cultivate these common traits and discover new methods to more effectively teach and provide care to those in need. - Phillip Ross, MD
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VISITING INTERNATIONAL HAND SURGERY FELLOWS
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
China 2014
Guang Yang, MD Jilin University China 2014
Takanobu Nishizuka, MD Nagoya University Japan 2015
Sandeep Jacob Sebastin, MD National University Hospital
Takeshi Ogawa, MD, PhD Tsukuba University
2010
2017
Singapore
Japan
Pao-Yuan Lin, MD Chang Gung Memorial HospitaL
Michiro Yamamoto, MD, PhD Nagoya University
2012
2017
Kaohsiung City, Taiwan
Shimpei Ono, MD, PhD Nippon Medical School Japan 2013
Keming Wang, MD Peking Union Medical College China
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2013
Yirong Wang, MD Peking Union Medical College
Japan
Yuki Fujihara, MD, PhD Nagoya University Japan 2017
Nasa Fujihara, MD Nagoya University Japan
2017
Taichi Saito, MD, PhD Okayama University Japan 2017
Sirichai Kamnerdnakta, MD Siriraj Hospital Mahidol University Thailand 2018
Hidemasa Yoneda, MD, PhD Nagoya University Japan 2019
Zhou Yu, MD Chinese Academy of Medical Sciences & Peking Union Medial College China 2019
Chun-Yu Chen, MD Kaohsiung Veterans General Hospital Taiwan
WHERE ARE THEY NOW? INTERNATIONAL SCHOLARS UPDATES
“After graduating with a Doctor of Medicine degree from Jilin University in China, I was admitted to the Department of Hand Surgery of China-Japan Union Hospital in 2007. My training in hand surgery continued under the guidance of Dr. Kevin Chung at the University of Michigan. This one-year training took place September 2013 to October 2014 as a visiting scholar sponsored by the China Scholarship Council. Under the mentorship of Dr. Chung, I observed him at clinic and in the operating room. During that time, I also conducted a series of reviews on the contralateral C7 transfer for the treatment of brachial plexus injury, of which the effectiveness and safety remains a subject of debate. Several peer-reviewed articles were published based on this study. After finishing my international fellowship at Michigan, I continued to work with Dr. Chung. As partners, five book chapters related to hand surgery and several academic articles were published. Currently, I am a professor in the Department of Hand
Surgery at Jilin University clinically focused on congenital anomalies of the hand.”
~Guang Yang, M.D. Department of Hand Surgery, Jilin University
“I am working as an Associate Professor for the Department of Hand Surgery at Nagoya University. I support many surgical cases related to osteoarthritis of the hand and elbow, TFCC injury, hand tumors, and pediatric hand problems. I often recall Dr. Chung’s surgeries while operating. My current project is on developing a next generation elbow arthroscopy combined with augmented reality navigation. We are also conducting a prospective multicenter study in Japan for Dupuytren’s contracture about collagenase injection vs fasciectomy. I hope all alumni and current staff are doing well.”
“I was an international fellow at the University of Michigan from 2010 to 2012. Afterwards, I studied clinical hand surgery knowledge and techniques at Seirei Hamamatsu General Hospital—one of the largest hand surgery centers in Japan. Starting in 2017, I became an Associate Professor at Nippon Medical School. I led approximately 200-300 hand surgery cases, from congenital cases to trauma, per year. I am now interested in functional and aesthetic reconstruction of the hand, particularly creating new useful perforator flaps based on anatomical and physiological research. Additionally, I am studying medical illustration and will be a professional medical illustrator in a few years. Thank you to everyone who supported me at Michigan.”
~Shimpei Ono, M.D., Ph.D., F.A.C.S Associate Professor in Nippon Medical School
“After I returned to Japan, I received a specialist of orthopedic surgery license in March 2018. Next, I graduated from Nagoya University Graduate School of Medicine in April, and received a Ph.D. degree. My current workplace is Aichi Cancer Center Hospital in Nagoya. I am now studying reconstruction of sarcoma patients.”
~Nasa Fujihara, M.D., Ph.D. Aichi Cancer Center Hosptial, Nagoya University
~Michiro Yamamoto, M.D., Ph.D. Department of Hand Surgery, Nagoya University
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AWARD RECIPIENT OF THE HAROLD E. KLEINERT TRAVELING FELLOWSHIP
TEAM PHOTO WITH DR. KENJI KAWAMURA In 2005, Dr. Kenji Kawamura was the first visiting international hand surgery scholar to the University of Michigan. This past fall, Dr. Kawamura returned to campus and was recognized as the first recipient of the prestigious Harold E. Kleinert Traveling Fellowship. The Kleinert Fellowship is an endowed traveling fellowship in honor of Dr. Harold Kleinert and his trainees. The fellowship is awarded to an international star traveling to the United States to visit the acclaimed Louisville Hand Center and other prestigious centers. Through his teaching and research, Dr. Kleinert made vast contributions to the field of hand surgery; to be associated with such a legend is a true honor for Dr. Kawamura. In 1999, Dr. Kawamura graduated from Nara Medical University in Japan and started an orthopaedic surgery fellowship thereafter. He trained in the programs of hand surgery and microsurgery at Nara Medical University Hospital. In 2005, Dr. Kawamura visited the 10
University of Michigan for six months as an international hand fellow of Dr. Kevin Chung. In 2010, he completed requirements to acquire a Qualified Hand Surgeon certificate by the Japanese Society for Surgery of the Hand. Since 2016, Dr. Kawamura has been working at Nara Medical University as an associate professor of Susumu
Tamai Limb Trauma Center. As a grateful recipient of the Kleinert Fellowship, Dr. Kawamura states, “I am honored to receive the first Harold E. Kleinert traveling fellowship. I was very happy to come back to Michigan as a part of my traveling fellowship. I visited the University of Michigan for three
DR. KAWAMURA’S PRESENTATION 3
and Louisville particularly struck him, especially for international surgeons. He remarks, “it is not easy to educate international hand fellows because they have different backgrounds of culture, language, economy, and health policy.” Currently, Dr. Kawamura’s practice focuses on hand, upper extremity, and microsurgery. He also has keen interests in basic science, biomechanics, and hand anatomy. He has a collaboration with Chiang Mai University in Thailand supporting cadaver research and would like to continue clinical and basic science research throughout his career. He hopes that he can take lessons from his time here.
DR. KAWAMURA AT ASSH
days before [the] American Society for Surgery of the Hand meeting in Boston. I observed interesting surgical operations and a lot of cases in [the] outpatient clinic. I also had an opportunity to give a lecture to residents and fellows. Compared to his visit to Michigan in 2005, changes did not go unnoticed. Dr. Kawamura was impressed with the enthusiasm from department staff, as well as physical changes to campus. He praised the students he met as “very smart and active.” As for the hospital itself, he says, “When I was an international hand fellow of Dr. Chung in 2005, there was a small children’s hospital. Now I am surprised that there is a big beautiful new children’s hospital.” All experiences in Michigan were wonderful. I thank Dr. Chung
and the staff for nice hospitality.” Overall, Dr. Kawamura found his fellowship and experience very valuable. Most important to him was the opportunities to form new relationships. During his travels, Dr. Kawamura met many prominent and influential physicians, as well as others who are young and promising.
“The educational and research system that Dr. Chung has made [at the] University of Michigan is excellent.”
As part of the Kleinert Fellowship, Dr. Kawamura visited three hand institutes in the United States: Washington University in St. Louis, the University of Michigan, and the Christine M. Kleinert Institute for Hand and Microsurgery in Louisville. He was excited to learn new surgical techniques at all three institutions. The excellent educational systems at Michigan 11
2018 ASSH MEETING CONTRIBUTIONS • Dr. Waljee was awarded the Bunnell Traveling Fellowship, considered by many to be the most prestigious award bestowed by the American Foundation for Surgery of the Hand. Congratulations, Dr. Waljee! ASSH Annual Meeting 2018
Michigan Hand Surgery was very well represented at the ASSH Annual Meeting. In addition to our involvement in scientific presentations, committee work, and instructional courses, our team garnered prestigious awards and accolades. Here are the highlights: • Dr. Chung was selected by the nominating committee to serve as Vice President for 2018-2019. His nomination was endorsed by the ASSH Council and confirmed by a vote of the membership at the Annual Business Meeting on Thursday. This places Dr. Chung in the presidential line—he will serve as President-Elect in 2019-2020, and as President from 2020-2021. He will preside over the 2021 meeting, which is currently scheduled to take place in San Francisco, Sep 30-Oct 2, 2021. Congratulations, Dr. Chung!
Dr. Jennifer Waljee, Bunnell Traveling Fellowhip Award
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• Dr. Waljee also served as CoChair for the 36th Adrian E. Flatt Residents & Fellows Conference. Our fellows agreed that it was a very enjoyable, valuable, and educational meeting. One of the highlights was the First Annual Hand Surgery Quiz Bowl Competition, a single-elimination bracket style tournament between resident/fellow teams from around the country! • Dr. Xuan “Liz” Qiu, one of our 2017-2018 fellows, presented in the enviable “Best Papers” Session on Thursday. Her presentation was titled “Cost-Effectiveness Analysis of Humanitarian Hand Surgery Missions According to WHOCHOICE Methods.” Co-authors were Jacob Nasser, Gloria Sue, James Chang, and Kevin Chung. Dr. Qiu also presented this research at the Precourse—Research Methods and Investigators’ Workshop. • Dr. Chung presented Outcomes After Revision Amputation or Replantation in FRANCHISE (Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction and Effectiveness) Study on behalf of the FRANCHISE group, an international consortium studying the outcomes of amputation and replantation.
• Dr. Hoyune “Esther” Cho presented “Finger Replantation Optimization Study Update on National Trends.” Co-authors were Lin Zhong, Sandra Kotsis, and Kevin Chung. • Dr. Chung moderated an instructional course titled: “Linscheid-Dobyns Excellence in Wrist Instructional Course: The University of Michigan Grand Rounds on Wrist Ligament Injuries, Casebased Discussions.” Panelists were Dr. Haase, Dr. Lawton, Dr. Waljee, and Dr. Paymon Rahgozar, a fellow from 2016-2017. It was Dr. Rahgozar’s award-winning wrist talk at the ASSH meeting in 2017 that secured this named, honorary instructional course for our Michigan group.
Dr. Xuan “Liz” Qiu ASSH podium presentation
• Dr. Ozer moderated an instructional course titled “Acute Compartment Syndrome to Volkmann’s Ischemic Contracture: A Spectrum of Disease.” Panelists were Dr. Lien, Dr. Apurva Shah, and Dr. Lawton. • Dr. Cederna participated in the instructional course “Upper Extremity Amputations: The Future Is Now!”, where he gave a talk on regenerative peripheral nerve interfaces.
• Dr. Lawton participated in the instructional course “Complications of Hand and Wrist Care,” where he gave a talk titled “Management and Prevention of PIP Fracture Dislocations.”
ASSH Panelists Dr. Haase, Dr. Rahgozar, Dr. Lawton, and Dr. Waljee
• Dr. Lawton also participated in the Postcourse “Scaphoid Injuries: State of the Art Management”, where he gave a talk on the use of 1,2-ICSRA dorsal flaps from the distal radius for scaphoid proximal pole fracture with AVN. • Poster “A Novel Method to Predict Ischemic Muscle Damage Following Reperfusion Injury: Single Muscle Fiber Contractility Testing”, by Emre Gok, MD; Fares Alghanem, MS; Dylan J. Sarver, PhD; Mark J. Hoenerhoff, DVM; Cristopher Mendias, PhD; Kagan Ozer, MD • Poster “Risk of Prolonged Opioid Use Among Opioid-Naïve Patients Following Common Shoulder Arthroscopy Procedures”, by Joseph A. Gil, MD, Vidhya Gunaseelan, MBA, MS, MHA, Steven F. DeFroda, MD, Chad Brummett, MD, Asheesh Bedi, MD, Jennifer F. Waljee, MD • Poster “Functional Outcome After Dynamic Hypothermic Ex-Situ Perfusion on Rat Hind Limb Allografts”, by Emre Gok, MD; Carrie Kubiak, MD; Erin Guy, MS; Alvaro
Rojas-Pena, MD; Robert Bartlett, MD; Stephen Kemp, PhD; Kagan Ozer, MD • Poster “Cross-Sectional International Multicenter Study on Quality of Life and Reasons for Abandonment of Upper Limb Prostheses” by Michiro Yamamoto, MD, PhD, Hirotaka Tanaka, MD, PhD, Takashi Nakamura, PO, Jumpei Oba, OTR, Kevin C. Chung, MD, MS, Hitoshi Hirata, MD, PhD • Besides the scientific work being presented, most of our hand surgeons are involved in multiple ASSH committees, working behind the scenes to serve the mission of this organization!
ASSH TRAVELING FELLOWS
ASSH traveling fellows The University of Michigan hosted six surgeons from the American Society for Surgery of the Hand’s International Traveling Fellows Program last fall. ASSH works with the International Federation of Societies for Surgery of the Hand (IFSSH)-recognized hand societies to select up to 20 international fellows each year. The fellows are given a rare opportunity to visit U.S. facilities in the weeks surrounding
the annual ASSH meeting. They receive complimentary registration and special recognition at the meeting. Dr. Byung Jun Kim from Korea, Dr. Christian K. Spies from Germany, and Dr. M. Rosa Morro from Spain visited Ann Arbor on September 5-7, 2018. They observed a full day of surgery with Dr. Kevin Chung and presented to the Michigan Comprehensive Hand Center group on topics of their choice. Dr. Spies presented on distal radio-ulnar joint instability, Dr. Morro on skin vascularization and flap surgery, and Dr. Kim on congenital hand differences. The visiting surgeons attended the Michigan Plastics Alumni Surgical Symposium (M-PASS) on September 7. The program included lectures and panel discussions on surgical technique, practice management, and global medicine. The traveling fellows then departed and visited several U.S. training programs before attending the ASSH annual meeting on September 1315 in Boston, MA. The second group of International Traveling Fellows were Dr. Eiko Yamabe, and Dr. Tsuyoshi Tajika from Japan, and Dr. Mischka N. Kolodzynski from the Netherlands. The group visited the University of Michigan September 20 – 21, 2018. After observing surgery in two of the the Comprehensive Hand Center staff. Dr. Yamabe presented on diffusion tensor imaging of the median nerve for carpal tunnel syndrome, Dr. Tajika on ultrasound and carpal tunnel syndrome, and Dr. Kolodzynski on hand surgery in the Netherlands. We are looking forward to hosting the next batch of ASSH fellows this year in September.
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ANNUAL VISITING PROFESSOR LECTURE
formities & burns, and neuromuscular conditions (brachial plexus birth injury, spinal cord injury, and cerebral palsy). She focuses on the child’s function and performance, especially from the patient’s own perspective.
Dr. James Lecture
VISITING PROFESSOR LECTURE, DANTO AUDITORIUM
The University of Michigan Department of Surgery along with hand surgery faculty and staff, were proud to host the 12th annual Visiting Professor Lectureship in Hand Surgery. Originally started within the Section of Plastic Surgery, each year the lectureship has featured premiere plastic and orthopaedic surgeons from across hand surgery. Past lecturers rank 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, Brent Graham, and Michelle Carlson. This year’s distinguished Visiting Professor of Hand Surgery was Dr. Michelle James, Chief of Orthopaedic Surgery at the Shriner’s Hospital for Children – Northern California, Chief of Pediatric Orthopaedic 14
Surgery at University of California Davis Health System, and a clinical professor of orthopaedic surgery at UC Davis Medical School. In addition to sharing her experiences in resource poor environments and on congenital hand malformations, she also led residents through a cadaver lab focusing on tendon transfers for patients with spinal cord injuries.
2019 VISITING PROFESSOR PROGRAM
Dr. Michelle A. James served as the keynote speaker in an exciting educational program for our faculty, fellows, and residents held April 25-26, 2019. Dr. James specializes in treating pediatric hand conditions, including congenital malformations, post-traumatic de-
Dr. James’ research interests include hand and upper extremity function, acting as Principal Investigator for seven funded studies (5 multi-center, 2 single site). Her current prospective funded studies include an investigation of early MRI diagnosis and prognosis of brachial plexus birth injury, and an evaluation of outcomes for children with hand burns. She has published over 100 articles in peer reviewed journals, recently serving as Co-Editor for the 4th Edition of Chapman’s Comprehensive Orthopaedic Surgery. In addition to being a clinical instructor at UC Davis and UC San Francisco, Dr. James has served as Director and Vice President of the American Board of Orthopaedic Surgery, Vice Chair of the Residency Review Committee of the Accreditation Council on Graduate Medical Education, President of the
Dr. James receiving visiting professor gift
Ruth Jackson Orthopaedic Society, and multiple committees within ASSH, POSNA, AOA, and AAOS. She is currently Deputy Editor for Hand, Upper Extremity and Topics in Training for the Journal of Bone and Joint Surgery. Dr. James was also a Deputy Editor for the Journal of Hand Surgery and Techniques in Hand and Upper Extremity Surgery. We were grateful to learn from Dr. James’ approach of treating spinal cord injuries, congenital malformations, and her extensive experience serving resource poor communities in Nicaragua. Lastly, residents and fellows were able to highlight some of their clinical and research expertise. Through clinical case and research presentations, ideas were exchanged between fellows and Dr. James as a leader in hand surgery. We look forward to planning another engaging educational program in 2020.
speaker in August 2017 followed by Dr. William Bowers from the Medical University of South Carolina in 2018. Dr. Bowers is a 1960 graduate of The Citadel (Charleston, SC) with a BS in Chemistry, a 1962 graduate of the University of North Carolina at Chapel Hill with a MS in Physical Chemistry, and he received a Doctor of Medicine degree in 1966. After his surgical internship at Chapel Hill, he entered the Army Medical Corps and became the Division Flight Surgeon for the 1st Air Cavalry Division in Vietnam (1967-68). He received the Combat Medical Badge, Bronze Star with Valor, 8 Air Medals with Valor, and 2 Purple Hearts. Following his army service, he completed his orthopaedic residency at UNC Chapel
Hill in 1973. He was then selected as an Anne C Kane Fellow in hand and upper extremity surgery at Columbia-Presbyterian Medical Center in New York City. He trained for one year with Dr. Robert E. Carroll. Dr. Bowers retired from private practice in 2006. He then joined the faculty of the Medical College of Virginia at Virginia Commonwealth University. He continues to teach orthopaedic and plastic surgery residents as the Director of Hand Surgery at the McGuire Veterans (MCV) Administration Hospital in Richmond, Virginia. He continues to publish his research interests with the collaboration of the MCV Department of Orthopaedic Surgery.
DISTINGUISHED HAND SURGERY LECTURESHIP First Annual Dean Louis Hand Surgery Lectureship Dean S. Louis, MD 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 University of Michigan faculty. During his 30 years at Michigan, he specialized in congenital hand problems ultimately serving as a past president of the American Society for Surgery of the Hand. Dr. Andrew Palmer was the first invited
DR. ANDREW PALMER HAND SUGERY LECTURESHIP 15
M-CHOIR
MICHIGAN CENTER FOR HAND OUTCOMES & INNOVATION RESEARCH
M-CHOIR STAFF
Front row, left to right: Sharon Kim, Jacob Nasser, Melissa Shauver. Back row: Sunitha Malay, Esther Cho, Pat Burns, Catherine Lu, Sandra Kotsis, and Kate Chang.
The M-CHOIR research group had another productive year. Our staff published 51 manuscripts in 19 journals and four textbooks. The research team was awarded four grants over the past year. As with every year, we say goodbye to some of our research team and welcome new people into our fold. Jacob Nasser, BS, started as a volunteer with us and became a research assistant after graduating from the University of Michigan with a degree in neuroscience. He has published 16 papers with an additional nine in the process of submission or publication. He also presented a paper at ASPS on economic analyses of plastic and reconstructive surgical trips. He will attend medical school at George Washington University this fall. Good luck Jacob! We welcomed Dr. Hoyune Esther Cho as our T32 fellow in 2018. Esther is currently working towards a master degree in health and health care research in the University of Michigan Medical School’s Institute for Healthcare Policy and Innovation, as a part of the Clinician Scholars Program. Over the last year, she was awarded a clinical grant from the American
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Foundation for Surgery of the Hand investigating patient and surgeon preferences in postoperative opioid use, published three papers and presented a paper at the 74th Annual Meeting for the American Society of Surgery of the Hand. We also welcomed three new research assistants: Shannon Wood, Natalie Baxter and Kristine Huynh. Shannon has volunteered with our group for all four years as an undergraduate at the University of Michigan. She graduates with a BS in Biomolecular Science with a minor in Gender in Health. Natalie is also a UM undergraduate and is receiving a BSE in Chemical Engineering. Kristine is a medical student at Oakland University. We expect great things from these three outstanding students. We would also like to acknowledge the long standing staff at M-CHOIR. In particular, our hardworking research coordinators - the unsung heroines of our team. This dedicated group is responsible for carrying out the day-to-day work for research studies, writing grants and papers, data management and analysis, and mentoring undergraduates, medi-
cal students, residents and fellows. Many of our research coordinators have worked for M-CHOIR for over 10 years. Thanks to Sandra Kotsis (20 years), Pat Burns (13 years), Melissa Shauver (12 years), Kate Chang (9 years), Sunitha Malay (7 years), and Catherine Lu (3 years) for all you do for our team! MAJOR PROJECTS WRIST: The Wrist and Radius Surgical Injury Trial (WRIST), is a 24site randomized study of distal radius fracture treatment in adults age 60 years and older. We have been hard at work analyzing 12-month data and writing papers. The first WRIST results paper was published in JAMA Open in February 2019. Two other papers have been accepted to PRS. Two are under review at NEJM and PRS. Another four manuscripts are in preparation. Finally, the 12-month WRIST results were presented in the Best Paper session at AAPS in April. Two WRIST studies will be presented at ASSH in September. The 24-month follow-up was completed in December 2018. We will begin the process of analysis and writing anew.
WRIST paper published in JAMA Open
FRANCHISE: The Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness (FRANCHISE) is a retrospective cohort study. We recruited 338 participants (176 treated with replantation and 162 with revision amputation) across 19 sites in the United States
CQIs and submitted it to a renown journal-- Plastic and Reconstructive Surgery.
FRANCHISE paper published in JAMA Surgery
and internationally. A manuscript comparing patient reported and functional outcomes was accepted to JAMA Surgery for publication. Other manuscripts assessing reliability and validity of outcomes and economic analyses are in preparation. M-CHIQS: Dr. Kevin Chung and Dr. Jessica Billig were awarded a two-year clinical grant by the American Foundation for Surgery of the Hand for their study, “Michigan Collaborative Hand Initiative for Quality in Surgery (M-CHIQS).” The aims of this study are to establish a regional collaborative initiative dedicated to improving quality in hand surgery and to develop and implement validated quality improvement metrics appropriate to hand surgery. The University of Michigan serves as the coordinating center for M-CHIQS consisting of nine sites. We have spent a considerable amount of time to complete the necessary administrative legwork to develop this project. Each site has applied for and/or received Institutional Review Board approval to collect data at their site. After identifying ways in which the treatment of hand surgery may vary, we developed a data collection form to collect information regarding variations in care and adherence to treatment guidelines. We plan to begin data collection by the end of May when each site has completed administrative paperwork. We wrote a paper describing the benefits of
Opioid Conjoint Analysis Project: In light of current efforts in healthcare to promote patient involvement in clinical decision-making, we are conducting a study to investigate the extent to which patient preferences are incorporated into current opioid prescribing practice in hand surgery. Our project consists of three specific aims to examine each step of the process by which hand surgeons and patients interact to decide on a plan for postoperative pain control after elective hand surgery. Our assessment on the integration of patient preferences into the postoperative analgesic plan will present an opportunity to understand the opioid prescribing practice from both a provider and a patient perspective. Currently we are carrying out a qualitative analysis with semi-structured interviews to explore patients’ decision making process and factors
Left to right: Sunitha Malay, Kate Change, Pat Burns Sandra Kotsis, Catherine Lu, Melissa Shauver
that influence opioid use for postoperative pain control. Then, we will use an innovative method of conjoint analysis to quantify the trade-off relationship between these influential factors. Data from this study will be used to design and plan a future intervention aimed at increasing patient participation in the decision-making process to decrease over-prescribing opioids and improve patient reported outcomes in hand surgery.
M-CHOIR 2018 ASSH ANNUAL MEETING ACCEPTED ABSTRACTS 1. Title: Industry Funding and Self-Declared Conflict of Interest in Hand Surgery Publications Authors: Phillip R. Ross, MD; Shannon Wood BS; Kevin C. Chung, MD, MS 2. Title: Litigation in Hand Surgery: A 30-Year Review Authors: Sarah E. Sasor MD; Kevin C. Chung MD 3. Title: Patient Satisfaction after Treatment of Distal Radius Fractures: An Analysis of Outcomes from the 24-Center WRIST Randomized Clinical Trial Authors: Kevin C. Chung, MD, MS; Sarah E. Sasor, MD (Presenter); Melissa J. Shauver, MPH; Kelly A. Speth, MS, for the WRIST Group 4. Title: Cost-Utility Analysis of Finger Replantation Comparing to Revision Amputation: Is the Additional Cost Justified by the Quality of Life Gained? Authors: Alfred P. Yoon, MD; Tanvi Mahajani, MHSA; David W. Hutton, PhD; Kevin C. Chung, MD, MS, and the FRANCHISE Collaboration
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MICHIGAN OPEN MICHIGAN OPIOID PRESCRIBING ENGAGEMENT NETWORK
Michigan OPEN Founders
Drs. Jennifer Waljee, Michael Englesbe, and Chad Brummett
Dr. Jennifer Waljee currently serves as a founder and co-Director of the Michigan Opioid Prescribing Engagement Network (Michigan OPEN). She is also an Associate Professor in the Section of Plastic Surgery at the University of Michigan School of Medicine. Launched in 2016 by Drs. Waljee, Michael Englesbe, and Chad Brummett, Michigan OPEN was founded to develop a preventive approach to the opioid epidemic in the state of Michigan. Michigan OPEN’s focus is on preventing patients in acute care settings (surgery, dentistry, and emergency medicine) from becoming chronic opioid users. This is achieved through an evidence-based approach to opioid prescribing and reducing the number of excess pills in homes and communities across the state of Michigan. Michigan OPEN relies on various data sources to inform their evidence-based approach. These range from private health insurance claims data, insurance claims from Medicare and Medicaid, data from electronic health records, patient 18
reported outcome data, and genomic data. Access to the data sets is possible through unique partnerships that Michigan OPEN has cultivated with various organizations including the Collaborative Quality Initiatives (CQI) program funded by Blue Cross Blue Shield of Michigan, the Michigan Department of Health and Human Services (MDHHS), and the Institute for Healthcare Policy and Innovation (IHPI). In addition to Drs. Waljee, Englesbe and Brummett, the Michigan OPEN team consists of research fellows, research assistants, and a team of clinical analysts, researchers, and outreach experts. To date, Dr. Waljee and her team at Michigan OPEN have: Published several high-impact research papers that inform opioid prescribing in the acute care setting. Developed and launched the opioid prescribing.info platform to provide evidence-based opioid prescribing and counseling recommendations for 25 common general surgery procedures. The recommendations are updated regularly and available
to the public, free of charge. Developed patient education materials on safe opioid use, storage, and disposal; which are available to the public for download and co-branding (with partner organization’s logos), free of charge. Hundreds of medical and dental practices have requested customized co-branded materials in 24 states and three countries. Hosted biannual take back events which have collectively removed 172,700 opioid pills and 9,600 pounds of used medications from communities across the state of Michigan. When asked, participants in take back events have consistently reported surgery as the most common reason for their opioid prescription. Michigan OPEN has been recognized within the University and beyond for its work.
In November 2018, Michigan OPEN was among honorees at the Greater Detroit Area Health Council’s annual Salute to Healthcare. In May, 2018, Michigan OPEN was awarded the University of Michigan Staff Impact Award, which celebrates those who champion volunteerism and service within the university, and who find ways to collaborate across units and find solutions to make the workplace better for all. The ceremony recognizes individuals and organizations who are working to improve the health and well-being of the southeast Michigan community. The Michigan OPEN team was awarded the 2018 Eagle Award for Visionary Leadership. To learn about Michigan OPEN, its work, and resources, please visit http://michigan-open.org/.
ANNOUNCEMENTS HAND CENTER PLANNING
The Comprehensive Hand Center will be part of the new East Medical Campus (EMC) located near the East Ann Arbor Surgery Center. Michigan Medicine has selected an architecture design firm to advance Phase I planning at the East Medical Campus. It is anticipated that this effort will include the Comprehensive Musculoskeletal Center, the MCHAMP Sports Medicine Program, Otolaryngology, Dermatology, and advanced rehabilitation services such as occupational and physical therapy, including hand therapy. Lastly, orthotics and prosthetic services will be on-site along with advanced imaging (MR, CT) and procedural space (outpatient operating rooms) to accommodate patients within a single campus. Michigan Medicine is currently discussing data, determining projections, and finding adjacencies among the teams that will have space at EMC. Over the next six months, a detailed plan will be developed that could advance to the Michigan Medicine Board and ultimately to the University of Michigan Regents. If the plan reaches final approval, construction would take approximately 3 years to complete.
A WARM WELCOME
Our new project manager, Justen Lewis has joined the Section of Plastic Surgery and Comprehensive Hand Center (CHC). He is project manager for Plastic Surgery 50% and CHC 50%. Justen is an alumnus of the university—undergraduate degree in public policy and master’s degree in health services administration. He has previous experience working in a govern-
ment setting and at a large health system—supporting ambulatory operations, business development, and strategic planning. Justen enjoys traveling, bowling, volunteering, and chess. His favorite cuisine is soul food and Mexican!
Justen Lewis, Project Manager
SARA studies.
HALL OF DISTINCTION INDUCTEE
Congratulations to Dr. Erika Davis Sears, MD, MS, who was inducted into her graduating high school’s Hall of Distinction in September 2018. The purpose of the Marion High School Hall of Distinction is to give lasting recognition to Marion High School graduates who have made exceptional contributions to the achievements and prestige of Marion Community Schools. Dr. Sears also met with current students in the Black History Club to speak about her career path since leaving high school. She offered advice on college preparation, financial aid, career aspirations, and why she chose medicine and plastic surgery for a career. Well done, Dr. Sears!
GRANT NEWS
Dr. Kevin Chung was recently awarded a U01 grant from the National Institute for Arthritis and Musculoskeletal and Skin Diseases. The Surgery of the Ulnar Nerve (SUN) study is a multicenter, randomized clinical trial to compare outcomes for two surgical procedures. Eligible patients will be randomized to receive in-situ decompression or anterior subcutaneous transposition. Researchers will enroll approximately 400 patients over 3.5 years. The team will then follow patients one year after surgery. Currently, 10 clinical sites are involved in the study. Additional collaborators will be sought over the next few months. The research team is excited to start another large trial and build on lessons learned from the WRIST and
Marion High School football game celebration
CHICAGO ASPS PODIUM PRESENTATIONS Jacob Nasser: “The Economic Sustainability of Plastic and Reconstructive Surgical Outreach Efforts in Low-and Middle-Income Countries.” William Chung: “The Biases That Exist in Plastic Surgery Survey Instruments.” 19
SMITH AND GRABB, 8TH EDITION
Drs. Chung, Gilman, and Cederna present Cozzi Grabb with the first copy of Smith’s Plastic Surgery, 8th edition textbook at the 2019 Reed O. Dingman Graduation Ceremony.
Dr. Kevin Chung surprised the Section of Plastic Surgery and Comprehensive Hand Center staff at the 2019 Reed O. Dingman Graduation Ceremony. He announced the return of the Grabb and Smith’s Plastic Surgery, 8th edition textbook, to the University of Michigan! Dr. Grabb served as Chief of Plastic Surgery before his untimely passing over 20 years ago. Authors of the Grabb and Smith’s Plastic Surgery textbook are fifty percent of Dr. Grabb’s trainees, faculty members, and past residents from the University of Michigan. In the words of Dr. Chung, “This book is truly Michigan.” Dr. Chung served as Associate Editor for seven years on the textbook and was finally asked to become Editor in Chief two years ago. It became his mission to reclaim the book back to Michigan where it belongs. The book was not scheduled to be published until September of 2020; however, Dr. Chung was able to have the book published one year ahead of schedule, a feat rarely accomplished in the publication world. Dr. Chung presented the very first copy of the 20
book to Mrs. Cozzi Grabb (wife of Dr. Grabb) during the 2019 Graduation. Mrs. Grabb was thrilled and honored to be presented with such a prestigious book and stated that she is “so proud” of the Section of Plastic Surgery and its accomplishments.
BOOK RELEASES
Over the past three years, Dr. Chung and his associate editors embarked on an ambitious journey to provide a three volume encyclopedia textbook on many 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 ASSH Surgical Anatomy: Flap Reconstruction, the newest guide to performing intrinsic, pedicled, and free-flap procedures used in operating rooms worldwide. Editors Kevin C. Chung and Steven L. Moran, worked closely with over 60 experts from around the globe to provide a simple, elegant, instruction on anatomy, indications, contraindications, surgical techniques, complications, outcomes, and essential surgical pearls and pitfall for over 40 flaps. Lastly, The University of Michigan’s Upper Extremity Fracture Surgery
Drs. Phillip Ross and Sarah Sassor at ASSH
was also published this year. This is a comprehensive guide to upper extremity fractures authored by University of Michigan faculty and affiliates. The expert publication was edited by Dr. Kevin Chung and Dr. Lawton. Section editors include Dr. Michael Freehill, Dr. Jeff Lawton, Dr. John Lien.
ORTHOPAEDIC SURGERY
Dr. Dean Louis
REMEMBERING DR. DEAN LOUIS AO TRAUMA NORTH AMERICA Hand and Wrist Fracture Management Course
The University of Michigan Orthopaedic Surgery hosted the 3rd Hand & Wrist Fracture Management Workshop on Saturday, October 27, 2018. Interest has remained strong. Thirty-three individuals attended ranging from junior residents, fellows, physician assistants, and attendings in the area. The University of Michigan has hosted this course since 2012 and it continues to enjoy strong support from the region with attendees coming from Canada and surrounding Midwestern states. Local faculty including Jeff Lawton, Kevin Chung, Kagan Ozer, Steve Haase, and Jennifer Waljee were joined by guest faculty Marco Rizzo from the Mayo Clinic and Kim Mezera from the Dallas Hand Center. A great environment with motivated learners was noted by many of the faculty in attendance. There was also continued interest from the Association for the Study of Internal Fixation in supporting the course. A biannual occurrence is expected in the future.
“BABY BOB”
Dr. John Lien, Assistant Professor
Congratulations to Dr. John Lien and Dr. Grace Jennifer Lee on the arrival of their baby boy, Michael Robert Lien, born March 6, 2019, weighing 7 pounds 2 ounces. Dr. Lien lovingly refers to the new edition to his family as “Baby Bob”.
Dr. Dean Louis, Professor of Orthopaedic Surgery, passed away on June 16th, 2019 at the age of 83. Dr. Louis was a devoted family man, passionate about the arts and music, a nature lover, and a true Michigan fan. Dr. Louis received his Doctor of Medicine degree from the University of Vermont and completed his orthopaedic surgery fellowship here at the University of Michigan. After completing a hand fellowship at New York Presbyterian hospital, Dr. Louis returned to the University of Michigan and joined hand faculty to care for patients with hand and upper extremity conditions. As a hand surgeon, Dr. Louis experienced many notable accomplishments— including the Certificate of Added Qualification in Surgery of the Hand from the American Society of Surgery for the Hand (ASSH). In addition to teaching at the University of Michigan, Dr. Louis organized multiple hand surgery reviews and post graduate courses for ASSH. Dr. Louis was a very active member culminating in his ascension to become the 51st president of ASSH in 1997. The Comprehensive Hand Center honors the legacy of Dr. Dean Louis for his indelible impact on the field of hand surgery. He will be remembered as an esteemed colleague, dedicated teacher, and respected scholar.
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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 the Physician Assistant (PA) teams and Hand Therapy teams. SOUTH MAIN PA TEAM “The orthopaedic hand PA’s practice is evolving and we are seeing more non-surgical patients independently. This frees up the surgical patients to have quicker access to care. Mike Wdowiak has expanded to both
Northville and Brighton centers offering surrounding communities the Michigan difference. We look forward to meeting the challenges of the next fiscal year providing excellent care in an ever changing health care setting.” ~Cecilia Fagan, PA-C DOMINO’S FARMS PA TEAM “The PA’s continue to work hard to see the hand patients in between surgeon appointments. Amy Holland and Kristen Gittins see over 4,000
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patients annually. Amy and Kristen give back to the medical community by lecturing for the EMU Physician Assistant program. Amy also lectured to the attendees of the Michigan Medicine Therapy Conference in March along with Drs. Haase, Chung, and Lawton.” ~Amy Holland, PA-C DOMINO’S FARMS HAND THERAPY
treatment of patients in the performing arts, hypermobility, arthritis, and scleroderma. We are welcoming, easily accessible, and well-rounded occupational therapists in the heart of Ann Arbor with extended hours to accommodate our patients’ needs.” ~Lexi Muir, OTRL, CHT
“Our hand therapy team includes 4 certified hand therapists with over 100 years of combined experience! We are a team who has worked together for nearly 10 years and treat primarily post-surgical patients within the Plastic Surgery Clinic at Domino’s Farms. Current projects SOUTH MAIN HAND THERAPY besides providing direct patient care include the following: co-authoring a “We ascribe to a patient centered research article on joint replacement environment through the use of outcomes, preparing for hosting/ speaking at our 2019 Michigan Medicine Hand Symposium: Current Surgical Interventions and Treatment for Complex Hand Injuries, attending the national conference in Philadelphia, and working on a committee on
knowledge, technique, music, humor, and community. We are privileged to work with a team of outstanding individuals, in all areas of care at South Main Orthopaedics.” ~Heather Nicholas, OT, CHT
learning health systems with PM&R.” ~Jeanne Riggs, OTRL, CHT NORTHVILLE HAND THERAPY “Hand therapy at Northville Health BURLINGTON HAND THERAPY Center includes Rachel Potocsky and Augusta Simmons, both CHTs. “As the largest hand therapy clinic at Rachel and Augusta offer unique perMichigan Medicine, we treat a wide range of diagnoses affecting the upper spectives with different backgrounds quadrant. We utilize innovative tech- and frames of reference for treatment. nology along with a holistic approach We enjoy being creative with splintto treating orthopaedic, post-surgical, ing and treatment techniques for our cumulative trauma and complex pain wide range of patients. Together, we patients. Our specialty areas include make a great team that allows for tra-
LOCATIONS
ditional treatment as well as innovation and improved outcomes for the patients at Northville Health Center.� ~Rachel Potocsky, OT, CHT BRIGHTON HAND THERAPY Julianne Shustock, OTRL, CHT and Paige Frey, OTRL are the two full time hand therapists working at Brighton Center for Specialty Care (BCSC). They treat a diverse caseload of diagnoses including crush injuries, digital amputations, flexor/ extensor tendon injuries, hand/ wrist/forearm/elbow fractures, elbow injuries including terrible triad and
Domino’s Farms Plastic Surgery
4008 Ave Maria Dr. Lobby A, Suite A 1200 Ann Arbor, MI 48105 734-998-6022
Huron Valley Professional Center-Orthopaedic Surgery Clinic 2098 Main St. Ann Arbor, MI 48103 734-998-6541
Comprehensive Musculoskeletal Center 39901 Traditions Dr. Suite 110 Northville, MI 48168 248-305-4400 734-763-2554 lateral collateral ligament repairs, Dupuytren disease, tendon transfers, tendon lengthening with high tone, brachial plexus injuries, arthritis, cumulative trauma, infant congenital anomalies, and nerve injuries of the upper extremity. Additionally, Julianne specializes in treatment of upper extremity spasticity/soft tissue contractures using various techniques including inhibitory/serial casting. Julianne and Paige evaluate and treat walk-ins at the clinic.
Burlington Building-Occupational Therapy 325 E. Eisenhower Pkwy Floor 2 Ann Arbor, MI 48108 734-763-6464
Brighton Center for Specialty Care 7500 Challis Rd. Brighton, MI 48116 (810)263-4000
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Ways to Give
• Making a contribution online: victors.us/umplasticsurgery • Mail a check to: Michigan Medicine Office of Development 1000 Oakbrook, Suite 100 Ann Arbor, MI 48104 specify UM Comprehensive Hand Center in the memo • Remembering Michigan Medicine in your will or estate plan • Contact us to discuss how we can achieve our shared goals. Matt Douponce at: mdoupo@umich.edu or 734-763-5392 © copyright 2019 Regents of the University of Michigan
Photo Credits: Carolyn McCarthy and Paul Trombley; Editor, Justen Lewis; Graphic Design, Jennifer Curley