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25th Annual Smith Day & Inaugural Jupiter International Forum

25th Annual Smith Day; May 30, 2014
Inaugural Jesse B. Jupiter International Hand Forum; May 31 – June 1, 2014
Royal Sonesta Hotel, Cambridge

Organized by: Hand & Upper Extremity Service,
Massachusetts General Hospital, Boston, MA
Written by: Teun Teunis, MD,PhD student from The Netherlands

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Thursday, May 29th, 2014:
After a rainy couple of days, feverish Smith Day preparations came to a conclusion. The conference started with a dinner at the Royal Sonesta Hotel, the meeting’s home base for the next couple of days. Although during the impending world cup emotions might be very different, this particular Thursday, Germans sat amicably alongside Americans; and Brazilians, Argentinians and Dutch cordially shared a glass of wine.

Our invited guest speaker, the Swiss Dr. Pietro Regazonni’s lively provocative talk entertained the crowd due to his familiarity with the Spanish, German and English language and by raising important issues in learning and training. Dr. Regazonni’s talk was followed by an intriguing talk on how our mind works and the awe-inspiring placebo effect by Dr. Ring. Both talks forshadowed a compelling conference to follow.

Friday, May 30, 2014:
The stakes for the Smith Day were high: 53 talks, 4 minutes per speaker, covering all aspects of upper extremity surgery. A relentless timer on every presentation reminded both the audience and the speaker there was always more to come. In addition to our Smith orator, Mr. Douglas Campell from England we had Drs. Andrew Koman, Pietro Regazzoni (Switzerland), Karl Prommersberger (Germany); Paulo Ruchel and Adriano Diniz (Brasil); Alberto Rios and Ivan Moreno (Argentina), and Josephine IP (Hong Kong).

The wide variety of topics sparked interesting discussions throughout the field; and – from a young researcher’s perspective – the more I learned, the more I realized how much I don’t know.

Discussions continued well outside the conference room, into the delightful Bostonian sun. And the Charles boulevard made a convenient place for further dialogue. The day was concluded by invited speaker Mr. Douglas Cambell from the UK the AO Hand Expert Group. His talk only further raised the bar for the coming inaugural International Jesse Jupiter Hand Forum.

Saturday, May 31, 2014 – Day 1
Inaugural Jesse B. Jupiter International Hand Forum

The first day of the Inaugural Jesse Jupiter International Hand Forum centered around upper extremity trauma. The day started at the fingers and, like a neuronal signal, moved upward through the arm. This was a high level course with a blurred line between faculty and participants. Short talks presented some topics for discussion. The exchanges form the majority of the course.

Richard Gelberman kicked off with flexor tendon injuries, follow by an interesting talk on nerve defects by Andrew Koman. Both topics came together during a discussion on complex index finger injuries by Neil Ford Jones.

Distal radius and carpal fractures were up next, for which Doug Campbell and Diego Fernandez seemingly posed more questions than answers, thereby outlining important directions for future research. Hill Hastings, Lee Osterman, and Peter Stern further expanded both topics.

Talks on the forearm were followed by elbow fractures. And after another thought provoking talk by Pietro Regazzoni, supplemented by Hill Hastings and Charles Cassidy, the topic of upper extremity trauma was adjourned.

The day was concluded by a moving and motivating speech by Jesse Jupiter himself. For a young doctor at the beginning of his career, the question “what makes a good surgeon” could not have been better timed. Also for the more experienced and laureate surgeons in the room the topic seemed to evoke contemplation and reflection. I’m eagerly looking forward to tomorrow’s forum continuation.

Sunday, June 1, 2014 – Day 2
Inaugural Jesse B. Jupiter International Hand Forum

The concluding second day of the Inaugural International Jesse Jupiter Hand Forum focused on the non-traumatic aspects of hand and upper extremity surgery. Trauma and fractures offered ample debate even though one might consider it more straightforward. Conversely, Sunday’s non-traumatic topics are more contentious, which I expected would only further increase discussion. I was not to be disappointed.

Dr. Ring started by reviewing the prior days discussions. Drs. Osterman and Gelberman offered additional insights and thoughts that he had omitted, resulting an inspiring summary of the state of hand and upper extremity trauma.

The prior revolutions in aviation safety, picked up by anesthaesiology and general surgery previously, formed the inspiration for Dr. Pietro Regazonni’s commencing talk on the surgical “black box” or “flight recorder”. Moderator Dr. Ring had a hard time managing the first discussions of the day after this thought provoking talk.

Not long after calm returned, the subsequent talks on radial tunnel and pronator syndrome by Dr. Neil Ford Jones and on enthesopathies by Dr. Lee Osterman, stirred conversation and controversy again, concluded by Dr. Hill Hastings’s talk on elbow arthritis.

After several case presentations by participants and faculty, Dr. Curtis Cetrulo gave an inspiring talk on MGH’s first hand transplantation and efforts to induce immune tolerance. Drs. Andrew Koman addressed tendinopathies, Diego Fernandez addressed arthritis, and Mr. Doug Campbell ganglion cysts. They explored ambiguities and important caveats in non-traumatic wrist surgery.

The day was concluded by great talks on hand problems by Drs. Richard Gelberman who approached the issue of carpal tunnel syndrome from the perspective Michael Porter’s ideas about value in health care. Dr. Gelberman also deftly guided us through a discussion of Dupuytren disease. The group had not lost enthusiasm at the end when Dr. Peter Stern guided a discussion of trapeziometacarpal arthrosis.

Many commented on how amazing it was to hear the wisdom, debates, and pearls of so many accomplished hand surgeons. With those great speakers this educational, fun, and–above all–inspiring Inaugural International Jesse Jupiter Hand Forum came to an end, leaving me yearning for next year’s meeting.

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