Hand & Upper Extremity Service

In 2012, David Ring, M.D., Ph.D., was named Chief of the Service following the legacy of Drs. Richard Smith, Richard Gelberman, and Jesse Jupiter, and also the excellent interim leadership of Dr. Chaitanya Mudgal. Dr. Ring is also the current President of both the New England Hand Society (NEHS) and the New England Shoulder and Elbow Society (NESES). In the realm of patient care, the MGH Hand Service performed its first hand transplant this year under the leadership of Dr. Curtis L. Cetrulo, Jr. of the Plastic Surgery Service. Dr. Cetrulo and the MGH transplant team hope to one day bring their attempts to induce tolerance to fruition, making immunosuppressive medications unnecessary.

It was a brilliant academic year. Dr. Mudgal led the fellowship through a successful internal review. The teaching program for the residents and fellows remains a strength of the service. We hosted Dr. Mark Baratz, a former resident with Dr. Rubash, from the University of Pittsburgh during our pre-New England Hand Society visiting professorship, and Dr. Bernard Morrey from the Mayo Clinic during the pre-New England Shoulder and Elbow visiting professorship.

The honored guest for the 24th Annual Richard J. Smith Day was Dr. Amit Gupta from the University of Louisville. As part of the Smith Day celebration we revitalized the Boston Hand Club Dinner as area hand surgeons and therapists gathered at Joe’s American Bar & Grill on the waterfront and were regaled during dessert by Dr. Gupta.

Plans for next year are even bigger. In addition to the pre-NEHS and NESES visiting professorships, we will have a four-day educational course. We will kick-off on May 29, 2014 with a hands-on AO Resident Skills Course run by Dr. Mudgal, followed by the Boston Hand Club Dinner. The 25th Annual Smith Day, with guest professor Tom Fischer of the Indiana Hand Center, will take place on May 30, 2014. Finally, the inaugural Jesse B. Jupiter International Hand Forum will take place on May 31-June 1, 2014.

We continue with innovative and influential research. The relationship with the Academic Medical Center in Amsterdam, the Netherlands remains strong. One PhD student successfully defended his thesis in the summer of 2012, another is set to defend in 2013; two are nearing completion of their work at MGH, one is halfway through, and several more are on their way. We said farewell to our German and Swiss PhD candidates last year and wish them well as they prepare to defend their theses. In addition, we’ve had dozens of short-term researchers from the Netherlands, Scotland, and Spain. They keep us busy and enthused.

The Service had several dozen original research publications this year, many of them international collaborations. We are particularly proud of a study of variation in disability with various common hand diseases. (Das De S, Vranceanu AM, Ring DC. J Bone Joint Surg Am. Contribution of kinesophobia and catastrophic thinking to upper-extremity-specific disability. 2013 Jan 2;95(1):76-81. doi: 10.2106/JBJS.L.00064.) As a culmination of prior work, we demonstrated that ineffective coping strategies such as catastrophic thinking (a tendency to over-prepare for the worst possibilities) and kinesiophobia (fear of movement) account for about half of the variation in upper extremity specific disability with the disease/impairment accounting for much less of the variation. The closing sentence of this abstract is becoming more widely understood and acknowledged: “The consistent and predominant role of several modifiable psychological factors in disability suggests that patients may benefit from a multidisciplinary approach that optimizes mindset and coping strategies”, as suggested by its acceptance in the JBJS.

Drs. Jupiter, Mudgal, Ring, and Sang-Gil Lee keep busy at the Ambulatory Surgery Center at Mass General West. Dr. Jupiter has recently started performing outpatient surgeries at Newton-Wellesley Hospital. We look forward to the expansion of our outpatient visits at MGW in the near future.

Finally, congratulations to Dr. Jesse Jupiter for being nominated for the 2012 John T. Potts, Jr., MD, Faculty Mentoring Award this past year. Well done!