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Program Structure

Two orthopaedic surgery residents, three fellows, and one plastic surgery resident are each assigned to one or more faculty member(s) who has some or all of their practice dedicated to hand and upper extremity surgery. The hand trauma call schedule includes a dedicated attending and hand fellow daily. Hand call includes replantation / microvascular emergency services, for which our institution is a major referral center for the entire southeastern United States. Our faculty appreciates a mentorship-type relationship with the fellows who are expected to participate in teaching residents and students and to gradually assume greater responsibilities in patient care over the course of the fellowship year, under the direct supervision of the faculty. Highlights of clinical exposure include:

  • Adult reconstruction includes experience in treatment of osteoarthritis (including post-traumatic) and rheumatoid arthritis for the upper extremity, arthroplasty of the elbow, wrist and hands, Dupuytren’s contracture, nerve compression syndromes, scleroderma and vascular insufficiency, and tendon reconstructions. In association with the orthopaedic oncology service, treatment of benign and malignant tumors of the upper extremity is included in the education of the residents and fellows.
  • Trauma includes treatment of fractures and dislocations of the upper extremity, flexor and extensor tendon injuries, nerve injuries, compartment syndromes, and replantation / microvascular emergency services. Experience is obtained for acute, sub-acute and chronic injury presentation.
  • Brachial Plexus and Peripheral Nerve Injuries include the evaluation and management of both adult and pediatric patients with traumatic and birth-related brachial plexus injuries as well as the treatment of acute and chronic peripheral nerve injuries.
  • Congenital hand includes treatment of all birth-related injuries, such as congenital absence of the thumb, radial and ulnar club-hand, syndactyly, and cerebral palsy.
  • Free-tissue transfer includes our significant experience with free vascularized fibular grafting, soft tissue reconstruction with local, regional, and distant tissue transfer.
  • Shoulder includes treating common shoulder conditions and developing innovations. Common surgical procedures performed include proximal humerus ORIF, shoulder arthroplasty, arthroscopic rotator cuff repairs, superior capsule reconstructions, and shoulder instability repairs. Fellows will gain experience common conditions and experience latest innovations of reconstruction using a new prosthesis and 3-D imaging to create solutions to increasingly challenging problems in shoulder and elbow surgery. 
  • Sports injuries include the management of sports-related and overuse injuries of the upper extremity. Common surgical procedures include Tommy John surgery, distal biceps tendon repair, TFCC repair, and UCL repair of the thumb. Fellows will gain a significant experience with wrist and elbow arthroscopy.

Clinic and Operating Room Experience

Fellows actively participate in both the clinic and the operative room. In the clinic and in the operating room, a structured mentorship education program encourages the development of examination skills, diagnostic test interpretation, treatment decision-making, pre- and post-operative management of patients with upper extremity disorders, and surgical techniques and principles.

Rotations

Each rotation is two months in duration. Fellows rotate with the senior faculty twice during the year.

Rotation

Monday

Tuesday

Wednesday

Thursday

Friday

Ruch 

Clinic

O.R.

Clinic

O.R.

O.R.

Richard

O.R.

O.R.

Clinic

O.R.

Clinic

Leversedge

O.R.

Clinic

O.R.

Clinic

O.R./Clinic

Conferences

The following conference schedule occurs on a weekly basis:

  • Tuesday: Core Lecture
  • Wednesday:  Core Anatomy / Surgical Skills Laboratory
  • Thursday:  Hand – Radiology Conference (1x/month)
  • Friday: Indications Conference