Hand & Upper Extremity
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THE HAND AND UPPER EXTREMITY SERVICE assumed the role of tertiary referral center for the New York tristate region during the peak of the COVID-19 pandemic, beginning in March and continuing through June. Our team treated patients with urgent and emergent musculoskeletal problems, including injuries of the upper extremities and peripheral nerves, at HSS and at NewYork-Presbyterian (NYP)/Weill Cornell Medicine.
In March 2020, the US Food and Drug Administration approved a new total wrist replacement device that was researched and designed by Scott W. Wolfe, MD. The device, known as the KinematX Total Wrist Implant, has distinct advantages over traditional implants due to a design that more closely matches the anatomy and motion of a normal wrist. This should allow for more natural motion and increased durability compared to currently available implants.
Dr. Wolfe also became one of just a few hand surgeons in the United States performing a new, highly technical procedure known as ANAFAB (anatomic front and back repair). ANAFAB involves the restoration of the critical ligaments that stabilize the scaphoid and collapsed central column of the wrist. It expands on the simplistic approach of addressing the scapholunate gap and combines multiple techniques to address the complex carpal mechanics. It presents a reconstructive option for patients with early SLAC changes that preserves carpal mechanics and should help to avoid a salvage procedure.
Dr. Wolfe and Steve Lee, MD, published the results of a study showing that neurolysis could be used to repair damaged nerves and restore muscle strength and movement among patients experiencing paralysis from Parsonage-Turner Syndrome.
During the past academic year, several leaders assumed new roles throughout the service: Dr. Lee as the new Service Chief; Daniel Osei, MD, MSc, as Fellowship Program Director; Aaron Daluiski, MD, as Research Director; and Samir Trehan, MD, as Education Director. This evolution in leadership has resulted in the restructuring of our academic syllabus and our trainee rotations in order to optimize their educational experience. We also successfully recruited Ameya Save, MD, to fill the Hand and Upper Extremity role for HSS at NYP. Dr. Save, who completed his fellowship training at HSS, has published numerous peer-reviewed papers and has presented his work at regional, national and international conferences. He was nominated to the Resident Leadership Forum of the American Orthopaedic Association and is a member of the American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand.
Role of Ligament Stabilizers of the Proximal Carpal Row in Preventing Dorsal Intercalated Segment Instability: A Cadaveric Study. Pérez AJ, Jethanandani RG, Vutescu ES, Meyers KN, Lee SK, Wolfe SW. J Bone Joint Surg Am. 2019 Aug 7;101(15):1388-1396. PMID: 31393430
Opioid Prescriber Education and Guidelines for Ambulatory Upper-Extremity Surgery: Evaluation of an Institutional Protocol. Stepan JG, Sacks HA, Lovecchio FC, Premkumar A, Fu MC, Osei DA, Fufa DT. J Hand Surg Am. 2019 Feb;44(2):129-136. PMID: 30033347
The direction of the Hand and Upper Extremity Service is driven by our core missions of clinical, educational and research development. With regard to education, the service leads on several major fronts. The Hand and Upper Extremity fellowship program continues to rise in both reputation and match results. The primary goal of the fellowship program is to train fellows in treatments for a wide range of conditions, from the most complex peripheral nerve dysfunction to more common sports-related injuries. We continue to train leaders in the field, both academically and clinically.
Patient registries help us examine the long-term effects of disease and the performance of surgical interventions and treatments, as well as provide a deeper understanding of the physical, psychological and socioeconomic impact for patients. They are a key driver of the unique feedback loop at HSS between patient care, research and new treatments.
As HSS continues to expand regionally, the Hand and Upper Extremity Service plans to increase our presence at these new sites. Our goal is to increase patient access to top hand surgeons outside of New York City.
We also plan to focus our efforts on creating initiatives to increase funding for research, education and clinical care. Educating and training the next generation of hand surgeons and developing our future leaders is of great importance to our program, and we are fortunate to have philanthropic support in this critical area.