Instructional Concurrent Session II
Do You See What I See? Viewing Imaging to Enhance Upper Extremity Treatment and Outcomes
Description:
Diagnostic imaging is a powerful tool that can inform and provide greater insight into your patient’s traumatic or insidious pathology. Reviewing and understanding Upper Extremity imaging, such as x-rays, MRI’s, CT scans, and US, can improve patient treatment choices and outcomes when managing musculoskeletal disorders. Remembering that, “we treat a person, not a diagnostic image”, and that diagnostic images never replace the critical learning from hands-on clinical assessments, we will explore some of the ways these images can benefit your clinical decision making and treatment planning. During this course we will present case studies in which the impact of the findings of diagnostic images were used to enhance patient treatment. We will begin laying a foundation by reviewing UE fracture classification, a systematic approach to reading images, clinical reasoning for choosing diagnostic images, incidental findings, unusual pathology, and some of the possible pitfalls of focusing too heavily on imaging. We will then apply this knowledge as we review the case studies. Knowing upper extremity anatomy will be essential to maximize benefit from this instructional course.
Objective(s):
- 1. Describe and compare normal UE imaging vs. abnormal UE imaging to identify pathology to impact patient treatment and outcomes.
- 2. Differentiate diagnositc criteria and clinical decision making for imaging choices.
- 3. Interpret and correlate clinical "Hands on" assessment findings with abnormal imaging results to formulate advanced treatment plan.
Speaker(s):
Management of Chronic Extensor Tendon Deformity, Reconstructions and Releases
Description:
This course with cover the surgical and therapy management of chronic injury to the extensor mechanism. The course will include a brief anatomy review, description of conservative and surgical management of chronic deformities, reconstructions and releases. Principles of surgical and therapy management will be illustrated through lecture and case presentations. Topics discussed will include: Anatomy and biomechanics review, Surgical Management of Extensor Tendon Deformity, Therapy Management of Extensor Tendon Deformity, Therapy Management of Extensor Tendon Reconstruction, and Therapy Management of Tenolysis/Capsulectomy.
Objective(s):
- Describe the extrinsic and intrinsic contributions to the extensor mechanism and how they affect management in different zones of injury.
- Recognize the different finger deformities caused by extensor mechanism injury and analyze the biomechanics of the deformity.
- Assess appropriate splinting and rehabilitation techniques for postoperative management of chronic extensor tendon injury.
Speaker(s):
Surgical and Therapeutic Considerations for Complex Distal Radius Fractures
Description:
Surgical management of the complicated distal radius fracture (DRF) will be discussed. Case studies will be utilized to demonstrate radiographic predictors to poorer outcomes and surgical considerations. The most common physician reported complications after DRF will be discussed including nerve compression, surgical site infection, complex regional pain syndrome, tendon ruptures, and tendonitis. Recent literature will be reviewed that has reported that individuals post DRF experience the same outcomes regardless of whether they have supervised hand therapy or a home exercise program. This lecture will examine recent evidence on the complications and complexities that are experienced in patients with a DRF who are frequently excluded from studies that examine effectiveness of hand therapy. Evaluation tools used to screen patients for complications including psychosocial impairments will be reviewed and effective interventions for complicated patients will be discussed.
Objective(s):
- Attendee will understand how radiographs can predict poorer outcomes in patients with DRF.
- Attendee will be able to describe complexities and complications that may be present in patients with DRF.
- Attendee will understand the use of evaluation tools to screen for complications post DRF and what interventions are effective.
Speaker(s):
Current Evidence in the Management of Lateral & Medial Epicondylitis
Description:
This course will cover the current best evidence for treatment of epicondylitis, from diagnostic considerations to orthotic selection and therapy approach, to injections and surgery. We will focus on high level evidence in the hand surgery, orthopaedic surgery and PT/OT arenas and emphasize therapist-physician collaboration for optimal care.
Objective(s):
- Discuss differential diagnosis and pathophysiology of epicondylitis; Understand indications for advanced imaging for epicondylar pain to help guide patients.
- Understand and apply current best evidence for hand therapy treatments, including eccentric vs concentric exercise, friction massage and modalities, and the application and use of braces and orthotics.
- Understand the role of more invasive therapeutic interventions, including steroid injections, platelet-rich plasma, and surgery in the management of recalcitrant epicondylitis.