International Symposium
INSTITUT DE LA MAIN
Surgery of the Spastic Upper Limb 2nd Announcement
March, 10th & 11th 2017 PARIS • FRANCE
VENUE / Fédération Française de Football
> Chairman: Caroline Leclercq > Members of the Hand Institute:
Choukri Dib, Alain Gilbert, Mathilde Gras, Stephane Guero, Alain Iserin, Caroline Leclercq, Christophe Mathoulin, Philippe Valenti, Anne Vidil
www.symposium-institutdelamain.com
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> Chairman
Caroline LECLERCQ (Paris, France)
> Scientific Committee
Michael TONKIN (Sydney, Australia)
> Organizing Committee
Mathilde GRAS (Paris, France)
> Faculty
Yves ALLIEU (Montpellier, France) Nathalie BINI (Padova, Italy) Adeline CAMBON-BINDER (Paris, France) Christopher COLBORNE (London, UK) Elena COSENTINO (Venice, Italy) Bertrand COULET (Montpellier, France) Philippe DENORMANDIE (Garches, France) Frank FITOUSSI (Paris, France) Christian FONTAINE (Lille, France) Sabrina GALLEGO (Medellin, Colombia) David GASQ (Toulouse, France) Werner GIRSCH ( Vienna, Austria Jean-Michel GRACIES (Créteil, France) Mathilde GRAS (Paris, France) Claudia GSCHWIND (Sydney, Australia) Christian HAGEMANN (Hamburg, Germany) Vincent d’HARDEMARE (Paris, France) Steven HOVIUS (Rotterdam, Netherlands) Serdar KOCER (Porrentruy, Switzerland) Scott KOZIN (Philadelphia, USA) Mick KREULEN (Amsterdam, Netherlands) Isabelle LAFFONT (Montpellier, France) Françoise LAPIERRE (Poitiers, France) Aleksandar LOVIC (Madrid, Spain) Joseph MAARRAWI (Beirut, Lebanon) Patrick MERTENS (Lyon, France) Nadine NACHEF (Lille, France) Türker OZKAN (Istanbul, Turkey) Paolo PANCIERA (Treviso, Italy) Catalina PAROT (Santiago, Chile) Renata PAULOS (Sao Paulo, Brazil) Simon PICKARD (Oswestry, UK) Eva PONTEN (Stockholm, Sweden) Carina REINHOLDT (Goteborg, Sweden) Francisco SOLDADO (Barcelona, Spain) Ann VAN HEEST (Minneapolis, USA) Carley VUILLERMIN (Boston, USA) Paolo ZERBINATI (Castellanza, Italy)
Dear colleagues and friends Welcome to the Symposium of the “Institut de la Main”, to be held in Paris (France) on March 10-11, 2017. This is the first time an international meeting is entirely dedicated to surgery of the spastic upper limb, both in adults and in children. International experts will discuss in depth the indications, techniques (videos only) and results of surgery, and there will be a special focus on evaluation, and clinical cases discussions. Whether surgeon, physiatrist, physical or occupational therapist, you are welcome to attend, and exchange your views with the experts. If you feel that you can make a valuable contribution to this meeting, please let me know. Looking forward to welcoming you in the city of Paris.
Caroline Leclercq
[email protected]
> Our partners 2017 ARTHREX CLINIQUE BIZET EYE RÉSOLUTION
HEMODIA KARL STORZ MEDARTIS
MERZ PHARMA SAURAMPS WRIGHT
International Symposium
INSTITUT DE LA MAIN
Surgery of the Spastic Upper Limb
Programme
Introduction
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Neurosurgical treatment
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Spasticity: an update
- Intrathecal baclofen and radicotomy - Intrathecal baclofen therapy in children: special considerations
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Evaluation: what does the surgeon need?
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- International Classification of Functioning, Disability and Health (ICF) - Assessment tools: SHUUE, AHA, MACS… Patient-based assessments: COPM, GAS… The role of video / EMG analysis - The sensory deficit - Pre-surgical evaluation
DEBATE: The ideal surgical assessment in children / in adults
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Clinical examination
- Key points of clinical examination - Video presentation of clinical examination - Attempted surgical classification of spastic upper limbs
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Non-surgical treatments:
• Botulinum toxin and surgery - Technique and preferences - Complications and so-called “failures” - Botulinum toxin + therapy intervention including splinting.
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Decision making: Goals, strategy and timing of surgery
- In children - In adult
// Surgical techniques & video session (5 mn video presentation of each technique)
• Muscle lengthening - Shoulder (video) - Medial epicondylar release and Scaglietti-Page (video) - Fractional lengthening (video)
• Multiple tenotomies: the shark attack - Technique (video), indications and results
• Partial neurectomies - Mechanism of action and evolution - Technique of selective neurectomy (video) - Long term results - Hyperselective neurectomy Anatomical basis Technique (Video: musculo-cutaneous, median, ulnar) Results
• Tendon transfers - Tendon transfer surgery Vs botox Vs regular ongoing therapy - Characteristics of the spastic muscle and biomechanics of tendon transfers in the spastic patient - Choice of donor muscle - Why tendon transfers in the growing child are unpredictable
• Invited lecture: 40 years’ experience of surgery of the spastic upper limb: evolution of my practice
International Symposium
INSTITUT DE LA MAIN
Surgery of the Spastic Upper Limb
//
Indications and Results
• Shoulder - Lengthening Vs neurectomy - Abd-ER deformity - Articular procedures (video): suspension, arthroplasty - Influence of shoulder surgery on distal function
• Elbow - Technique of elbow release (video) - Partial release - The role of the biceps - Results: Anterior release and self-esteem - Lengthening combined with neurectomies - Indications of elbow arthrolysis - And how about the triceps?
• Pro-supination - The forearm: the forgotten joint - Classification and indications - Pronator Teres rerouting (video) - Augmenting supination (video) - One bone forearm for fixed supination contracture DEBATE: how to avoid hypercorrection?
• Wrist - Medial epicondylar release (video) - Restoring the balance / tendon transfers Assessment of the Flexor carpi ulnaris Why I no longer transfer the spastic FCU What to do when tendon transfers don’t turn out as expected? ECU rerouting - Wrist arthrodesis: Technique (video), indications and results Wrist arthrodesis in adolescents Partial arthrodesis Impact of wrist arthrodesis on proximal function - Kienbock and Spasticity
Programme
• Thumb - Classification - First web release: techniques (video) - EPL rerouting (video) - MPj instability: capsulodesis / vs sesamoid metacarpal arthrodesis - Temporary and permanent fusion
• Fingers - Scaglietti- Page / vs fractional lengthening - STP transfer: technique (video), and complications - Alternative to STP: tenotomy-lengthening (video) - Tendon transfers to the finger extensors - Indications to tendon transfers to the finger flexors - Anatomy of the interosseous muscles (video) - How do we assess the intrinsic muscles? - Intrinsic release: technique and postoperative - Feasibility of percutaneous release of the interosseous muscles (video) - Swan-neck deformities: lateral band rerouting and other techniques - Boutonnière deformities
• Specifics of children : - Involuntary movements (dystonia, athetosis…). Can surgery help ? - Long term results - Should we operate adult CP patients?
• Specifics of adults : - Management of severe deformities: finger flexor tenotomies at the bedside(video) - Hopeless cases: beyond surgery ?
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Miscellaneous
- Surgery in adult CP patients - Tetraplegia and spasticity - Spastic missions in developing countries
// The future // Discussion of clinical cases
VENUE
Fédération Française de Football 87, bd. de Grenelle 75015 Paris - France
ONLINE REGISTRATION
www.symposium-institutdelamain.com
GENERAL ORGANIZATION
44 bd. Périer - 13008 Marseille Tel.: +33 4 91 94 54 72 Fax: +33 4 91 58 54 94
[email protected]
