Note: All handouts will be posted one week before the conference. 

Handouts for Thursday, May 9, 12:00pm-5:00pm CT

One Page Agenda PDF

*Slides are Subject to Change* Presenters can change slides without notice. The slides listed below are what we currently have on file. The Handout PDF is the same version that will be printed for in-person attendees.  

Anatomy and Kinesiology of the Wrist: Reviewing the Essentials

Donald A. Neumann, PhD, PT, FAPTA, Professor Emeritus Marquette University, Milwaukee, WI

An overview of the primary osteo-ligamentous organization of the wrist will be presented. A discussion will follow on the morphology of the proximal and distal rows of carpal bones, with special attention to the differences between the radiocarpal and midcarpal joints. The unique contribution that each joint has on overall wrist kinematics will be reviewed, with a spotlight on the functional ROM at the wrist and the unique kinematics of the dart thrower’s motion. The muscular drive across the wrist will be analyzed, with an emphasis on understanding the primary synergies and how kinetic balance is normally achieved at the wrist. Finally, a summary of how the position and stability of the wrist influences active and passive forces within the extrinsic digital flexors will be presented.

Surgical Management for Ulnar Impaction Syndrome

Alexander Graf, MD, Froedtert & Medical College of Wisconsin, Wauwatosa, WI

This presentation will describe the anatomy of the ulnar wrist, introduce the diagnostic approach to distinguishing different etiologies of ulnar-sided wrist pain, and then review the various surgical options for Ulnar Impaction Syndrome.

Forearm Rotation Limitations Following Trauma

Lisa Kozden, Ph.D., OTR, CHT, COMT, University of Scranton and Hands For Life Therapy, LLC, Plains, PA

Injuries to the elbow can often result in significant stiffness, limiting a person’s ability to perform daily activities. Stiffness in the elbow capsule due to trauma or immobilization can create limitations with both elbow flexion and extension as well as forearm rotation. Join us to learn more about manual techniques you can readily apply in the clinic to maximize motion at the elbow and forearm to optimize your patient’s occupational performance!

Clinical Manual Assessment of the Wrist

Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT, Hand to Shoulder Center of Wisconsin, Appleton, WI

What is the most challenging type of hand therapy diagnosis to evaluate? Is it a patient with a crush injury involving multiple fractures and tendon repairs or….is it the young girl with progressive onset of wrist pain? Hand therapists are typically well-versed in the “rhythm” of evaluating post-operative patients; however, performing a wrist evaluation for a conservative patient presenting with wrist pain can sometimes be daunting. Using a systematic approach combining findings from the patient’s history, clinical examination, and special tests, hand therapists can more efficiently determine the underlying pathology and provide appropriate treatment to optimize clinical outcomes.

Handouts for Friday, May 10, 8:00am-5:30pm CT

One Page Agenda PDF

*Slides are Subject to Change* Presenters can change slides without notice. The slides listed below are what we currently have on file. The Handout PDF is the same version that will be printed for in-person attendees.

Distal Radius Fracture: When to Operate, When to Cast?

Greg Watchmaker, MD, The Milwaukee Hand Center, Milwaukee, WI

Clinical and radiographic outcomes of distal radius fractures do not tightly correlate. Many factors can influence decision-making regarding surgery vs. closed management. The role of the hand therapist can differ between these two groups with regard to timing of therapy, specific modalities and exercises, and patient expectation setting regarding visible deformity. This lecture explores the science behind a common fracture with significant treatment variability.

Cadaveric Dissection – Distal Radius Fracture

Greg Watchmaker, MD, The Milwaukee Hand Center, Milwaukee, WI

A cadaveric dissection of the distal forearm and wrist highlighting anatomy pertinent to patients suffering distal radius fractures.

Distal radius fractures seem to have a bad reputation in the clinic, such as not very interesting, a dime-a-dozen, etc. This could not be farther from the truth! Fractures of the distal radius are fascinating. Fracture patterns are innumerable and often mechanically complex. Fixation methods are numerous and technically intriguing. Studying distal radius fractures, evaluating surgeon fixation choices, and predicting hand therapy challenges is like solving a puzzle. This presentation will be heavily image-based. Numerous x-rays and CT scans will be presented and discussed. This presentation is the culmination of many months of collecting examples of images and discussions with attending hand surgeons. It is a body of work that is fluid and constantly growing as cases come through the presenter’s clinic.

Movement is a complex human function that relies on sensory feedback, motor control and strength. Many movements used in daily activities are habitual and automatic, requiring very little thought, but when dysfunction occurs, previously simple movement patterns become challenging. Neuromuscular re-education is an important therapeutic technique addressing motor skills to facilitate return to full function after a disruption.

How Neuromodulation Coaching Affects Occupational Performance

Lisa Kozden, PhD, OTR, CHT, COMT, University of Scranton and Hands For Life Therapy, LLC, Plains, PA

Treating patients with wrist pain can be challenging based on everyone’s occupational history and performance needs. Neuromodulation coaching is a unique treatment approach which helps to assess and categorize each patient into specific archetypes with associated neurophysiological profiles. By understanding each patient’s archetype, a clinician can create and implement more effective plans of care which address the physical, mental, and emotional health of the patient. Join us to learn more about Neuromodulation coaching and how it can help improve the occupational performance of patients with wrist pain.

Surgical Management of Scapholunate Injury

Steven Kempton, MD, SSM Health Saint Mary’s Hospital, Milwaukee, WI

This presentation will provide an in-depth look at the scapholunate ligament, ruptures, and the associated carpal instability as well as current surgical management of these injuries.

Salvage Procedures for Scaphoid Lunate Advanced Collapse (SLAC)/Scaphoid Nonunion Advanced Collapse (SNAC) Wrists

Curtis Crimmins, MD, Hand to Shoulder Specialists of Wisconsin, Milwaukee, WI

This presentation will provide an overview of anatomy of the carpus along with a review of predisposing causative factors for conditions of both a scaphoid lunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) including scapho-lunate instability, scaphoid fractures, radius fractures, and idiopathic onset. Surgical treatment options and when to choose them will be presented including radial styloidectomy, full scaphoidectomy, 4 corner fusion, proximal row carpectomy, capitate resurfacing, total wrist, and wrist fusion.

Rehab Principles Following Scapholunate Injury

Jemerie Hopkins, MS, OTR, CHT, Froedtert & Medical College of Wisconsin, Wauwatosa, WI

The presentation will provide a brief overview of scapholunate ligament injuries (SLLI) and a comprehensive summary of the rehabilitation process. Emphasis on the importance of evidenced- based approaches in SLLI recovery, and encouragement for health care providers to stay updated on the latest therapeutic treatments and techniques for optimal outcomes will be presented.

A lot of time, effort, and study has gone into perfecting the physics of a work station. Categories of faults have been identified (trunk flexion, neck extension, point loading, shoulder elevation, etc.). The marketplace is well stocked with “ergonomic devices.” Handouts have been perfected with comprehensive bullet point lists and artists’ renderings of perfect posture at a desk. There is a missing piece, the person sitting at the desk is an office athlete. Solving their musculoskeletal aches and pains with equipment and patient education alone may not be enough. The office athlete deserves a careful, focused evaluation of their upper extremity movement system including the length, strength, and performance of the muscles of the upper quarter. Clients deserve a targeted home exercise program to address imbalances and prepare for the very real physical challenges of a desk job. Drawing heavily on the work of Shirley Sahrmann, PT, PhD, FAPTA, this presentation will apply a movement system impairment (MSI) syndromes approach to the evaluation and treatment of an office athlete.