4th annual Jupiter International Forum and 28th annual Richard Smith Day

Jupiter Forum - Review

"Ex Luna, scientia"
4th Annual Jesse B. Jupiter International Hand Forum

April 22, 2017
Jonathan Lans, Research Fellow

Dr. Jupiter and Dr. Morrey at the 4th Annual Jupiter Forum with the Hand and Arm Center at Massachusetts General Hosptial
Dr. Jupiter & Dr. Morrey

The day started where we ended yesterday. Looking at the schedule today everyone was excited to get a step closer in becoming an expert of the elbow. Nearly all topics regarding the elbow were touched upon: trauma, reconstruction and peripheral nerve pathology. All this under a watching eye of the two ‘true’ columns of the elbow: Dr. Jupiter and Dr. Morrey. If you want your child to follow in their footsteps, call him Bernard, “it’s all in the name.”

The day was inflammatory; Dr. Morrey shared so much of his wide knowledge on the elbow, frequently citing one of his 400+ publications on the spot. It was very clear that the faculty dinner yesterday evening did everyone well because the experts were on fire. There was a lot of discussion and interaction between the presenters and the audience. Dr. Ring helped us on a small flight to ‘hand therapy land’ emphasizing the importance of diversity amongst a medical team. We should never forget the importance of the hand therapists: they make sure that the patients play their part in recovery after surgery. We saw a live proof of their benefit, as Dr. Chen's elbow was as good as new after a quick joint oscillation and distraction session.

Dr. Dr. Morrey speaking at the 4th Annual Jupiter Forum with the Hand and Arm Center at Massachusetts General Hosptial
Dr. Morrey

We are bridging the gap in peripheral nerve surgery, but we want Moore. There is a lot to learn in nerve transfers and supercharging nerves, because rats are not humans, at least not in the room today. Furthermore, belief is very strong in many medical decisions and being aware of its power, allows you to control it. As Saint Augustine echoed more than 1500 years ago “Faith is to believe what you do not see; the reward of this faith is to see what you believe” To feel rewarded: manage the patient’s expectation, the patient may feel great even if they have a adverse effect of a surgery. Quoting Dr. Cohen “…doctor thank you, my surgery is successful, even my pinky is tingling…”

The conference room got cold as we approached lunch, but this did not hold back Dr. Jupiter who was as hot as a firecracker. He took us through his life becoming a renowned orthopedic surgeon. He inspired everyone to stay curious and critical. In what other way could you discover the Tushy-sign in capitellar shear fractures. This gave everyone food for thought during lunch.

After lunch we got some insight on how not do squats or bench presses with some footage from Dr. Kimball’s gym. This way we don’t need to worry about rupturing our triceps or biceps tendon. Tennis elbow was a hot topic once again and we have learned that we have to be careful that it may concur with a contagious disease: Worker's Compensation.

If you ever feel like "Houston we got a problem" during an elbow surgery think of what Dr. Morrey or Dr. Jupiter taught you today. Dr. Morrey took us through his remarkable journey from being part of NASA's Apollo XIII team to the Mayo Clinic. It was amazing to learn how aerospace engineering knowledge helped him develop the Coonrad-Morrey total elbow arthroplasty. We were honored and thankful to have Dr. Morrey with us and wish him all the best with his wife and family and a safe return back to his wonderful Elbow Bend Ranch.

One last request for all the bright minds in the crowd today. Please don't put your great ideas in textbooks, they will get lost. We want to hear them! Hopefully you will bring them with you next year to the 5th Annual Jesse B. Jupiter International Hand Forum.

Smith Day - Review

"The genie is out of the bottle"
28th Annual Richard J. Smith Memorial Lectureship

April 21, 2017
Jonathan Lans, Research Fellow

Dr. Cohen with the Smith Family at the annual Smith Day with the Hand and Arm Center at Massachusetts General Hosptial
Dr. Cohen with the Smith Family

A foggy and rainy Friday morning was quickly forgotten as soon as the meeting started. This year we had an eagle eye view over the Charles River and Beacon Hill from the 15th floor of the Wyndham Hotel.

Dr. Mudgal kicked off the meeting, setting out the rules for the day, not forgetting to point out everyone’s drink coupon. This year we were lucky to have Mark S. Cohen from Chicago as the orator, and everyone was curious for his tips and tricks on how to win the World Series.

We started with excellent presentations on topics regarding wrist injuries, infections in i.v. drug users, microsurgical teaching and nerve reconstruction. Let me start with some good news, if you are >40 you do not need to worry about TFCC signal changes in MRI, most patients are asymptomatic. You thought you knew how to handle the web? Wrong, a great anatomic dissection of webspaces showed that there is a ligamentous structure that configures the web. Astonishingly, burns of the web treated without skin grafting have amazing results.

Luckily, we did not lose any presenters, Dr. Mudgal had warned everyone that if the presentations took longer than 5 minutes they would be ejected from the stand! With great help of Chris McCarthy and Sophie Strike the microphones flew through the room allowing everyone to question the presenters. One last note of the morning: “statistics is like a bathing suit, what it shows is great, what it hides is even better”

After a small culinary trip to Italy it was time to bring it up a notch. Dr. Jupiter had chosen patient preferences above surgeon preferences, joining the meeting after some operative cases in the morning. Dr. Ring had also arrived from Austin and he shared his insights regarding patient communication. Say sorry to patients, they will feel heard. Opinions in the crowd were: “…that touching the patient is also not the problem, as long as it is not on the wrong spot…”

We finished off the meeting with a treat. Dr. Cohen wonderfully took us through his experience becoming a hand surgeon, explaining the great role Dr. Smith played: as a person and as a teacher. Like every year, this Richard Smith Day was a great learning experience and inspiring for everyone. Thank you very much for your input and your attendance and we are looking forward to see you tomorrow at the 4th annual Jupiter International Forum.

 

The genie is out of the bottle
28th Annual Richard J. Smith Memorial Lectureship

April 27, 2017
Jonathan Lans, Research Fellow

A foggy and rainy Friday morning was quickly forgotten as soon as the meeting started. This year we had an eagle eye view over the Charles River and Beacon Hill from the 15th floor of the Wyndham Hotel.

Dr. Mudgal kicked off the meeting, setting out the rules for the day, not forgetting to point out everyone’s drink coupon. This year we were lucky to have Mark S. Cohen from Chicago as the orator, and everyone was curious for his tips and tricks on how to win the World Series.

We started with excellent presentations on topics regarding wrist injuries, infections in i.v. drug users, microsurgical teaching and nerve reconstruction. Let me start with some good news, if you are >40 you do not need to worry about TFCC signal changes in MRI, most patients are asymptomatic. You thought you knew how to handle the web? Wrong, a great anatomic dissection of webspaces showed that there is a ligamentous structure that configures the web. Astonishingly, burns of the web treated without skin grafting have amazing results.

Luckily, we did not lose any presenters, Dr. Mudgal had warned everyone that if the presentations took longer than 5 minutes they would be ejected from the stand! With great help of Chris McCarthy and Sophie Strike the microphones flew through the room allowing everyone to question the presenters. One last note of the morning: “statistics is like a bathing suit, what it shows is great, what it hides is even better”

After a small culinary trip to Italy it was time to bring it up a notch. Dr. Jupiter had chosen patient preferences above surgeon preferences, joining the meeting after some operative cases in the morning. Dr. Ring had also arrived from Austin and he shared his insights regarding patient communication. Say sorry to patients, they will feel heard. Opinions in the crowd were: “…that touching the patient is also not the problem, as long as it is not on the wrong spot…”

We finished off the meeting with a treat. Dr. Cohen wonderfully took us through his experience becoming a hand surgeon, explaining the great role Dr. Smith played: as a person and as a teacher. Like every year, this Richard Smith Day was a great learning experience and inspiring for everyone. Thank you very much for your input and your attendance and we are looking forward to see you tomorrow at the 4th annual Jupiter International Forum.

Overview

April 20-22, 2017
AO Boston Hand & Wrist Course  |  Richard Smith Day  |  Jupiter International Forum
Wyndham Hotel, Boston

April 20, 2017: 3rd Boston AO Hand & Wrist Course

AO North America logo

This course is designed to teach participants, at every level of training and practice, to analyze hand and wrist fractures and to apply a treatment methodology based upon fracture management principles rather than upon any one implant, group of implants or singular universal technique. These AO Principles will be stressed: anatomic reduction; stable fixation; preservation of the blood supply; functional aftercare; and early mobilization.

Register for the AO Course. This is a separate registration from the Smith Day/Jupiter Forum registration.

April 21, 2017: 28th Annual Richard Smith Day
Smith Day is in honor of Dr. Richard Smith, who served as the Chief of the Hand and Upper Extremity Service from 1972 until 1987. Smith Day is a time for hand surgeons to present their original research and discuss this research with their peers. Dr. Smith was devoted to education, the pursuit of excellence and the advancement of the specialty of hand surgery, and Smith Day commemorates his legacy. The Smith Orator is Mark S. Cohen, MD.

April 22, 2017: 4th Annual Jupiter International Forum
This year's 4th Annual Jesse B. Jupiter International Hand Forum is dedicated to "The elbow: trauma, its aftermath and . . . . " A group of national and internationally renowned surgeons will address the current concepts and current areas of debate in upper extremity trauma. The 4th Annual Jupiter Oration will be delivered by Bernard Morrey, MD.

AO Hand & Wrist Course

Register for AO Course
(separate registration from Smith Day/Jupiter Forum)

3rd Annual AO Hand & Wrist Course

Course Description

This course is designed to teach participants at every level of training and practice to systematically analyze hand and wrist fractures and to apply a treatment methodology based upon fracture management principles rather than upon any one implant, group of implants or singular universal technique.

These AO Principles will be stressed:

  • Anatomic reduction
  • Stable fixation
  • Preservation of the blood supply
  • Functional aftercare
  • Early mobilization

Target Audience

Enrollment in this course is encouraged for surgeons, hand fellows, and residents in plastic, orthopedic and general surgery.

Richard Smith Day

Registration

28th Annual Smith Day: April 21, 2017

The Smith Orator is Mark S. Cohen, MD.

If you would like to present your research, please email an abstract to Chaitanya Mudgal, MD at cmudgal@partners.org.

2017 Smith Orator: Mark S. Cohen, MD

Dr. Mark Cohen, Smith Orator 2017

Mark S. Cohen, MD is the 2017 Distinguished 28th Annual Richard J. Smith Orator.

Dr. Cohen earned his BS degree with Highest Distinction and Departmental Honors at Stanford University, Stanford, CA in 1982. He continued his education at Harvard Medical School, Cambridge, MA where he graduated with his MD degree Magna Cum Laude with Honors in a Special Field in 1986. He then completed his surgical residency, including a one year spine clinical/research fellowship, at the University of California, San Diego from 1986-1992. This was followed by a one year hand and microvascular fellowship at the Indiana Hand to Shoulder Center.

Since 1993, Dr. Cohen has been on staff at Rush University Medical Center. He became a full professor of Orthopaedic Surgery in 2004 and has served as the Director of the Orthopaedic Hand and Elbow Section for the past 23 years. He is also the Director of Orthopaedic Education in the Department. Dr. Cohen is a team physician and consultant for the Chicago White Sox and the Chicago Bulls.

Dr. Cohen is the author of more than 121 medical articles and 56 book chapters, and he has written a textbook on Hand and Wrist injuries. In addition, he is an editor of Green's Operative Hand Surgery, the most widely read and recognized Hand and Elbow Surgery textbook in the world. He has participated in over 300 continuing education courses, serving as Course Chairman 45 times.

Dr. Cohen has won several research, teaching and achievement awards, and he is a member of 16 national and international medical societies and associations. Dr. Cohen was selected as one of Chicago's "Top Doctors" in Hand and Orthopaedic Surgery by Chicago Magazine in 1997, 2001, 2004, 2006, 2008, 2010, 2012, 2014 and 2016, every year the "Top Doctors" edition has been published. U.S.News & World Report rates him in the top 1% of physicians in his specialty in the nation. His clinical and research interests focus on fractures and reconstruction of the hand, wrist, and elbow with a special emphasis on minimally invasive surgery. Dr. Cohen has special training and expertise in complex elbow conditions, including elbow trauma and reconstruction.

Richard Smith, MD

Richard J Smith Day

Richard Smith, MD was an extraordinary individual and one who will not be easily replaced. Henry Mankin, MD, in writing Richard Smith’s obituary in the Journal of Bone and Joint Surgery in 1987, stated so eloquently, “his capacities, talents, and commitment made him, in the eyes of man, our finest flower and the thirty years he gave to hand surgery, one of its finest periods.”

Dr. Smith was born in the Bronx, New York, attending the prestigious Bronx High School of Science. He received his college education at Brown University, graduating in 1951. His medical education was obtained at New York Medical College, where he was elected to AOA and graduated in 1955. Following a surgical internship at Bellevue Hospital, Richard began his Orthopaedic surgical training at the Hospital for Joint Diseases in New York City, completing the program in 1960. During his training at the Hospital for Joint Diseases, he became a disciple of Emmanuel Kaplan, M.D., a then leading authority in anatomy of the hand and became determined to pursue a career in the relatively new field of hand surgery.

Following a two-year obligation to the Public Health Service in Boston, Richard Smith spent a year of Hand Fellowship, divided between Mr. Guy Pulvertaft in Darby, England and Dr. Joseph Boyes in Los Angeles, California. In 1963, Dr. Smith returned to the Hospital for Joint Diseases to join Dr. Kaplan and later in 1968 to succeed him as the Director of the Hand Service. During this time, he began to quickly establish himself as an outstanding clinician, surgeon, and most of all, educator.

In 1972, Richard moved to Boston along with Henry Mankin, M.D. to become the Chief of the Orthopaedic Hand Service at the Massachusetts General Hospital and, in 1980, was named Professor of Orthopaedic Surgery at Harvard Medical School. During his tenure at the MGH, which ended tragically with his untimely death in 1987, he expanded his activities in hand surgery to an international level and in 1982 served as President of the American Society for Surgery of the Hand. Despite all his commitments, he somehow found the time to be a devoted husband to his wife Jane and a devoted father to his daughters Lisa and Tracey, and late son James.

For all who had the unique good fortune to have known Dr. Richard Smith, studied under him, or worked with him in any capacity, what will endure most of all was his remarkable skill and devotion to education, the pursuit of excellence, and the advancement of the specialty of hand surgery.

Jupiter International Forum

Registration

Jupiter International Forum: April 22, 2017

The Jupiter Orator is Bernard Morrey, MD.

See the 2017 agenda

Course Description

This activity is targeted towards orthopaedic surgeons, plastic surgeons, and general surgeons with an interest in hand and upper extremity surgery. Experienced hand and upper extremity surgeons—particularly those that are involved in teaching, research, and writing—need a course that goes beyond didactics. Through an interactive setting where areas of debate and variation are addressed dynamically with the lines between faculty and participants being blurred, this course will provide experienced surgeons with a forum where they can get feedback on new ideas and find best practices or consensus directions for future research. Participants will benefit from immediate feedback on where concepts and practices fit within the best evidence and standard approaches. Using vignettes, cases, and debatable issues, moderators will play the role of provocateur, raising the breadth and depth of opinion for discussion, and reinforcing the scientific methods and systems approaches that can reduce unwarranted variation, and optimize care of hand and upper extremity illness, leading to improvements in leaner competence and performance.

2017 Jupiter Forum Orator: Bernard F. Morrey, MD

Dr. Bernard Morrey, Jupiter Forum Orator 2017

Bernard F. Morrey, MD is the emeritus chair of the Department of Orthopedics at Mayo Clinic. He is the John and Posy Krehbiel Professor of Orthopedic Surgery at Mayo and Professor of Orthopedics at the University of Texas Health Science Center, San Antonio. He is a Fulbright Scholar and a former member and consultant to the Food and Drug Administration Orthopedic Device Panel. He has been medical director of Tenex Health since 2011, was elected to the Board in March 2016, and elected as the interim CEO in October 2016.

Dr. Morrey was reared in Ft. Worth, Texas, and worked at NASA as an aerospace engineer for two years before receiving an MD degree from the University of Texas Medical Branch. He was trained in Orthopedic surgery at the Mayo Clinic during which time he also received a master’s degree in biomechanics from the University of Minnesota. After two years of service in the Air Force, he was awarded the Meritorious Service Award. He was on the staff at Mayo from 1978-2010.

Dr. Morrey holds nine patents for orthopedic devices, and he has authored 12 major textbooks under four different titles. These works have been translated into six languages. He has authored over 415 peer-reviewed publications. He is the personal orthopedic surgeon to the senior President and Mrs. Bush and has been named a distinguished alumnus from St. Bernard College, the Mayo Clinic, the University of Texas Medical Branch, Galveston. He has served in a number of extramural professional capacities, including Past President of the American Academy of Orthopaedic Surgeons, Past President of the American Orthopaedic Association, and Past President of the American Shoulder and Elbow Surgeons. He has been the chair of the Board of Trustees of the Journal of Bone and Joint Surgery and also for the Journal of Shoulder and Elbow Surgery. He served for eight years on the Board of Governors of Mayo Clinic where he was primarily responsible for strategic planning and financial analysis and performance of the Mayo practice. He is a founding member of the Abernathy Group Physician Family Office Board of Directors dealing with physician financial planning.

Dr. Morrey and his wife, Carla, an RN, have four children, Michael, Matthew, Mark and Margaret (Maggie) who are all involved in the medical profession. They have 12 grandchildren.

Jesse B. Jupiter, MD, Honored Sage

Dr. Jesse Jupiter, Jupiter International Forum, Hand and Arm Center, Mass General

Dr. Jesse Jupiter

Jesse B. Jupiter, MD, MA is Professor of Orthopaedic Surgery at MGH. He earned his MD at Yale in 1972 and completed his surgical internship at the University of Pennsylvania Hospital in 1973.

Following, Dr. Jupiter completed a two-year commitment as a general medical officer in the US Public Health Service Indian Health branch with the Pima Indians in Arizona. His interest in medical education was enhanced with the development of educational programs improving primary care for both diabetic and arthritic patients.

In 1975, he began the Harvard Combined Orthopaedic Residency Program. In 1980, Dr. Jupiter traveled to Basle, Switzerland where he completed an AO Fellowship after which he completed a hand and microvascular fellowship in Louisville, KY.

He returned to Boston in 1981 and began his academic and clinical career at MGH. During his 33 years on the faculty he has had the opportunity to head the Trauma Service, Foot and Ankle Program and the Hand Service.

Dr. Jupiter is an honorary member of more than 20 international societies of either Hand Surgery or Orthopaedic Surgery and has been named to America's Top Surgeons annually and Best of Boston since 2007.

Dr. Jupiter is an internationally known and sought after hand and upper limb specialist. He has given more than 1000 scientific presentations, published more than 220 original publications, 140 analytic reviews, 115 chapters in scientific texts and was co-author or co-editor of 10 major texts in upper limb and orthopaedic problems. Dr. Jupiter has developed a worldwide reputation, especially related to problems of the wrist and elbow along with all other conditions involving the hand and upper limb.

Agenda

7:00am Registration & Breakfast  
7:55am Introductory remarks Chaitanya Mudgal, MD
Session 1: Fracture of the Distal Humerus (Moderator: Neal Chen, MD)
8:00am Radial nerve palsy in fractures of the humerus: To explore or not to explore? Neal C. Chen, MD
8:20am Intra-articular fractures of the distal humerus: Strategies for internal fixation Chaitanya Mudgal, MD
8:40am The role of total elbow arthroplasty Bernard F. Morrey, MD
9:00am Post-traumatic elbow stiffness: When to intervene and how? Mark Cohen, MD
9:20am Rehabilitation after distal humerus fractures Gae Burchill, OTR/L, MHA, CHT
9:30am Morning break & exhibit hall  
Session 2: Nerve Pathology about the Elbow (Moderator: Kyle Eberlin, MD)
9:45aam High ulnar nerve and median nerve injury: Repair v/s graft and other augmentative strategies Amy Moore, MD
10:05am Nerve transfers about the elbow: Indications, methods and outcomes Joanathan Winograd, MD
10:25am Ulnar nerve compression at the elbow: What does the data tell us? Kyle Eberlin, MD
10:45am compressive neuropathies about the elbow: Are they unicorns? Amy Moore, MD
11:05am The role of the ulnar nerve in elbow trauma and reconstruction Neal Chen, MD
11:20am Honored Sage Oration: Elbow fracture - Lessons learned over my lifetime Jesse Jupiter, MD
Noon Lunch & exhibit hall  
Session 3: Soft Tissues about the Elbow (Moderator: Sang-gil Lee, MD)
1:00pam Tendon injuries: When to fix and what are the outcomes? Hervey Kimball, III, MD
1:20pm Soft tissue coverage about the elbow Matthew Iorio, MD
1:40pm Tendinopathies about the elbow: Where is the science? David Ring, MD, PhD
2:00pm Collateral ligament injury: When to repair, reconstruct and how to? Luke OH, MD
2:20pm Rehabilitation after soft tissue repair/reconstruction Carol Harmon Mahony, OTR/L, MS, CHT
2:30pm Afternoon break & exhibit hall  
Session 4: Fractures of the Proximal Radius & Ulna (Moderator: Hervey Kimball, III, MD)
3:00pm Monteggia fracture-dislocations: Pearls and pitfalls Charles Cassidy, MD
3:20pm Radial head fractures: When to fix and when to replace? Chaitanya Mudgal, MD
3:40pm The terrible triad: Is it so terrible in 2017? Charles Cassidy, MD
4:00pm Olecranon fractures: Do they all need to be fixed and does it matter how they are fixed? David Ring, MD, PhD
4:20pm Heterotopic ossification about the elbow: Assessment and treatment strategies Mark Cohen, MD
4:40pm Jesse Jupiter Oration: Total Elbow Arthroplasty - It’s not Rocket Science Bernard Morrey, MD
5:25pm Closing remarks Chaitanya Mudgal, MD
5:30pm Course adjourns  

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