Preliminary Program

FACULTY MEMBERS

Nathalie BINI (Torino, Italy)
Bertrand COULET (Montpellier, France)
Graine COLGAN (Dublin, Ireland)
Caroline LECLERCQ (Paris, France)
Paolo PANCIERA (Treviso, Italy)
Jean Gabriel PRÉVINAIRE (Berck-sur-Mer, France)
Pascal RIGAUX (Berck-sur-Mer, France)
Nadine STURBOIS-NACHEF (Paris, France)

Thursday 20 October 2022
07:30 Registration, morning coffee
08:00 Introduction to the surgical treatment of the Spastic Upper Limb
08:10 Clinical examination
08:30 Botulinum toxin and nerve blocks:
- Technical tips, general indication
- Botulinum toxin and surgery: a necessary pair
09:00 Non-surgical treatment
- Medications, physiotherapy,orthoses
09:30 When to decide on surgery: Debate
09:50 Coffee break
10:20 Surgical Strategy: a systematic approach
10:35 Hyperselective Neurectomy:
- Principles, Indications and results
- Discussion
11:05 The spastic shoulder
- The spastic shoulder muscles
- Surgical principles
11:30 Around the elbow:
- The three elbow flexors
- The spastic triceps
12:10 The spastic forearm:
- Pronator Teres and supinator muscle
12:30 Clinical cases
12:50 Lunch on site
13:50 Around the wrist:
- Rebalancing the wrist
- Stabilizing procedures:
radio-carpal fusion
medio-carpal fusion
14:30 Postoperative rehabilitation
14:50 Spastic deformities of the fingers
- Extrinsics
- Intrinsics
- Discussion
15:40 Coffee break
16:10 The spastic thumb:
- The deforming factors
- Surgical strategy
16:45 Specificity strategies:
- Children cerebral palsy
- Adult cerebral palsy
- The non-functional hand in the stroke patient
17:20 Clinical cases
17:40 Future tools?
- Cryoneurotherapy
- Nerve transfers
- Anatomical feasibility of nerve transfers
18:00 Adjourn



Friday 21 October 2022 SURGEONS OBSERVERS
07:30 Registration, morning coffee
08:00 Lecture Introduction to the workshop X X
08:15 SHOULDER 
15 min Lecture surgical techniques shoulder X X
15 min Demo Tenotomy / lengthening of PM, TM, LD, SS X X
60 min Dissection (same) X
60 min Lecture Clinical examination of the shoulder   X
09:45 Lecture HSN technical tips X X
10:00 Coffee break
10:30 ELBOW
15 min Lecture Elbow X X
15 min Demo Elbow HSN + flexor lengthening X X
60 min Dissection (same) X
60 min Lecture Botulinum toxin   X
12:00 FOREARM  1: Hyper-selective Neurectomy (HSN)
15 min Demo HSN median + ulnar nerve forearm X X
45 min Dissection (same) X
45 min Lecture HSN and botox: similarities and differences   X
13:00 Lunch on site
14:00 FOREARM 2 +/- finger extrinsics
20 min Lecture Techniques of release and lengthening X X
20 min Demo Epicondylar release, Zancolli, PT, fractional, STP X X
60 min Dissection Epicondylar release, Zancolli, PT, fractional X
60 min Lecture Muscle release or neurectomy? / Rebalancing / Problem of the fingers X
15:40 Coffee break
16:10 TENDON TRANSFERS
15 min Lecture Techniques of tendon transfers X X
15 min Demo Transfer FCU / ECU to Wrist Ext. // PT rerouting X X
60 min Dissection (same) X
60 min Lecture + discussion Post-op regimen / Questins and answers X
17:40-18:15 Clinical cases presentation X X



Saturday 22 October 2022 SURGEONS OBSERVERS
08:00 Morning coffee
08:30 WRIST ARTHRODESIS
15 min Lecture Technical challenges / associated procedures X X
20 min Demo Medio-carpal fusion
Total wrist fusion 		 X X
75 min Dissection (same) X
75 min Lecture + discussion Evaluation and classification of the spastic upper limb / finger interossei   X
10:20 Coffee break
10:50 THUMB
15 min Lecture Thumb anatomy, and techniques X X
15 min Demo HSN thumb intrinsics (median + ulnar) X X
15 min Demo First web release // EPL tenodesis // (BR to EPL) X X
70 min Dissection First web release // EPL tenodesis // (BR to EPL) X
70 min Lecture General decision making: timing, physio, orthoses, contra-indications,dystonia, lower limb, other…   X
12:45 Lunch on site
14:00 FINGER INTEROSSEI 
15 min Lecture Anatomy and techniques  X X
15 min Demo Distal / proximal tenotomy (2 fingers, neurotomy motor branch ulnar nerve, swan neck + STP X X
60 min Dissection Distal / proximal tenotomy (2 fingers, neurotomy motor branch ulnar nerve, swan neck + STP X
60 min Lecture + discussion Setting up a spasticity clinic /Questions and answers X
15:15-15:45 Clinical cases presentation X X
16:00 End of the Master Class