2026 ASSH/ASHT On Demand CME Webinar: Electives in Hand Surgery-Recording

Video Transcription

Video Summary

The 2026 Electives in Hand Surgery webinar covered comprehensive advances and best practices in hand and upper extremity surgery and therapy, featuring experts from top institutions. The program began with flexor tendon repair, highlighting that while core surgical principles remain consistent since mid-20th century, recent research focuses on optimizing biology and rehabilitation through early active motion and minimal pulley venting. Hand therapists emphasized individualized rehab protocols informed by surgical technique and patient-specific factors to balance preventing rupture and adhesions.<br /><br />Unicondylar phalanx fractures, often sports-related, were detailed with surgical fixation options including K-wires, screws, and plating, emphasizing early motion to reduce stiffness. Therapy for finger fractures stressed education, edema control, and tailored mobilization strategies to regain full function.<br /><br />Management of the mangled hand focused on meticulous initial debridement, ongoing evaluation of salvageability, staged reconstruction, and early hand therapy to optimize functional recovery. Catastrophic injuries require coordinated surgical and therapeutic strategies with psychological support, recognizing patients’ long recovery journeys.<br /><br />Wrist session addressed scaphoid fractures with imaging guidance, early fixation benefits, and therapy focusing on immobilization and progressive motion. The TFCC's complex anatomy and treatment algorithm—favoring non-operative care initially but surgery for instability or failed conservative management—were reviewed, alongside advanced therapy emphasizing proprioception and activity modification.<br /><br />Athletic wrist injuries require considering high load-bearing mechanics, sport-specific wrist use, and collaborative management between surgeons, therapists, and trainers to facilitate safe return to play with tailored rehab emphasizing dynamic stabilization and kinetic chain integration.<br /><br />Elbow topics discussed distal humeral fractures’ surgical approaches and fixation principles, severe elbow injury rehab emphasizing early motion and pain management, and lateral epicondylitis management prioritizing therapy with limited use of injections and surgery as last resort. Elbow arthritis treatment options included joint-preserving surgery and interpositional arthroplasty, with therapy focusing on comprehensive assessment, pain control, range of motion, and functional training.<br /><br />The nerve session explored pronator syndrome diagnosis and multifocal entrapments, cubital tunnel revision surgery strategies, therapist perspectives on comprehensive nerve assessments, and nerve laceration repair techniques emphasizing timely, tension-free coaptation. Adjuncts like intraoperative electrical stimulation may enhance regeneration. Therapeutic management highlighted individualized rehab with education, protection, graded mobilization, sensory re-education, and monitoring for complications, underscoring surgeon-therapist collaboration for optimal outcomes.<br /><br />Overall, the webinar emphasized the importance of integrating surgical advances with tailored rehabilitation and multidisciplinary communication to improve patient function and recovery trajectories in complex hand and upper extremity conditions.

Keywords

hand surgery

upper extremity surgery

flexor tendon repair

early active motion

pulley venting

unicondylar phalanx fractures

surgical fixation

hand therapy

mangled hand management

scaphoid fractures

TFCC treatment

athletic wrist injuries

distal humeral fractures

lateral epicondylitis

nerve entrapment