Cadaveric Dissection Course Birmingham Hand Centre & University Hospital Coventry and Warwickshire Nov. 17th 2014 £165 Venue Cadaveric Dissection Lab, Ground Floor, UHCW, Coventry CV2 2DX. Course Organiser Mr Mark Brewster - Hand Surgery Consultant QEH, Birmingham. Faculty Mr Mike Craigen, Mr Dominic Power, Mr Simon Tan, Mrs Jill Webb Mr Garth Titley & Mr Rajive Jose – Consultant Hand Surgeons, QEH, Birmingham Miss Helen Whalley – Hand Surgery Consultant, UHCW, Coventry This course is designed for trainees in plastic and orthopaedic surgery who want to improve their operative anatomy of the forearm and hand. The course has a loose agenda with scope for delegates to tailor the day to their needs. There are 28 delegates; 2 delegates per limb and 8 consultant faculty members to direct and advise on approaches and dissections. Beverages will be available throughout the day for delegates to take breaks as they feel and lunch will be provided. To purchase a place please go to; http://www.qehb.org/shop/tickets-and-events/bhc-hand-surgery-courses/ 8.15 am 8.30am 9am-12pm 12-1pm 1-4.30pm 4.30pm Meet at Costa Coffee in the main foyer Introduction to lab – rules and regulations Hand dissections Lunch Forearm dissections Debriefing and close NB – NO REFUNDS WILL BE GIVEN IF A DELEGATE CANCELS THEIR PLACE HOWEVER WE ALLOW A DELEGATE WHO CANNOT ATTEND TO ORGANISE A COLLEAGUE TO TAKE THEIR PAID PLACE INSTEAD EVEN AT SHORT NOTICE Please email – [email protected] for queries Recommended Hand Dissections / Approaches Finger 1 – Remove nail, Midline split germinal matrix and appreciated proximity of terminal extensor insertion to matrix, continue dorsal midline incision to MCPJ to appreciate extensor hood – identify intrinsics, Triangular ligament, ORL, transverse retinacular ligament, sagittal bands. Finger 1 – Chamay approach to PIPJ Finger 1 – cut FDP at insertion and see how far retracts Finger 2 – mucous cyst rotation flap for DIPJ coverage Finger 2 – volar midline incision and perform Z-plasties Finger 2 – reveal all pulleys and identify each then release between A2 and A4 to expose volar plate and perform joint release – check reign ligament (preserve transverse digital artery), VP, access collaterals. Finger 3 – Mid-lateral approach Finger 3 – Perform trigger release then expand incision to see boundries of A2 pulley Finger 3 – release all pulleys to view chiasm and by pulling on FDS in palm and observe it gripping FDP with finger held in extension Finger 3 – extend incision proximally to view lumbrical attachment to FDP and distal tendon passing volar to deep transverse MC lig Finger 3 – dissection out pulleys and tendons to view collateral insertion at PIPJ on volar 1/3 of MP Finger 4 – Cross finger and reverse cross finger flap Finger 4 – TATA procedure Finger – Kite flap, Quaba flap Fingers 1-4 flexor repairs Thumb – Moberg flap Thumb – Expose nerves and follow to CT and follow FPL to wrist Thumb – see pulley and do trigger release Hand – CTD, see in base of CT where carpal bones lie Hand – Extend CTD distally to see Sup palmer arch and follow median nerve to common digital nerves, find recurrent motor branch of median nerve . Hand – Wagner approach to trapezium and Bennets fractures – raise FCR graft for eaton littler procedure around trapezium Hand – Dorsal approach to trapezium Hand – Guyons Canal release and see fascicles of ulna nerve Recommended Forearm Dissection / Approaches Volar – Henry approach to wrist, identify PCB Med nerve, preserve FCR paratenon Volar – Periosteal flap for PQ and scaphoid approach volar, identify RSC lig Volar – Radial forearm flap Volar – Volar radius complete exposure Volar – Cubital fossae anatomy – release median nerve compression site, PIN Volar – LCNF harvest Radial – Radial nerve decompression and de Quervains release Dorsal – Zaidemberg periosteal graft Dorsal - EIP to EPL transfer Dorsal - Midline approach, step cut in ER, Berger approach to wrist, SLIL view and prox scaphoid, PIN and AIN neurectomy from posterior Dorsal – 5th EC enter DRUJ and preserve and repair TFCC, see stability of DRUJ before and after cutting TFCC Dorsal – PIA flap Dorsal – PIN decompression proximally Berger flap Kocher approach - radial head Misc. additional dissections Lateral arm flap Ulna nerve decompression and view FCU branches and MCN A and FA Flexor sheath washout Palmaris extension graft and Camitz transfer Expose 1st dorsal web to see radial artery Reveal deep palmar arch Review dorsal branch of little and index for Dupuytrens dissections UCL approach to thumb