Rotations

Dr. Green and Dr. Saucedo's Rotation.  You will work with Dr. Green in clinic at The Hand Center on Wednesdays.  On Monday afternoons, you will see patients in the VA clinic with Dr. Saucedo and orthopaedic surgery residents.  On Tuesday, the fellow and resident, under the direct supervision of Dr. Saucedo, will work together in the surgical management of VA patients. Generally acting as the supervising surgeon, the fellow teaches and assists the resident through surgical cases, thereby gaining mastery of these procedures through instruction and performance.  In the remainder of the workweek, the hand surgery fellow works with Dr. Saucedo, who sees and treats a wide variety of conditions in pediatric and adult patients, including acute and cold trauma from fingertip to elbow, post-traumatic sequelae, congenital hand differences and "typical" elective conditions, such as cubital and carpal tunnel syndrome, thumb CMC arthritis and trigger digit, to name a few.

Sample cases include:
VA- wrist fusion, open carpal tunnel release, ray amputation, cubital tunnel release with submuscular ulnar nerve transposition, distal radius malunion osteotomy, proximal row carpectomy, MPJ arthroplasty and fusion for rheumatoid arthritis
Saucedo - distal radius fractures (including closed reduction percutaneous pinning, fragment-specific and bridge plate fixation as indicated, in addition to volar locked plating), malunions of the wrist and forearm, hand fractures (closed treatment as well as open and percutaneous techniques), scaphoid fractures, DRUJ reconstruction, radioscapholunate fusion, ulnar shortening osteotomy, flexor tendon repair and reconstruction, syndactyly (primary and revision), thumb duplication (Wassell IV and Wassell III), thumb CMC mini-tightrope suspensionplasty, percutaneous ECRB debridement (TENEX procedure).

Dr. Bagg's Rotation.  You will spend an average of 2.5 days in the OR and 2 days in clinic. You will encounter a wide breadth of orthopaedic cases, including shoulder and elbow arthroplasty.  The fellow will encounter “cold trauma cases” throughout the entire year, but the majority of fractures proximal to the elbow are treated while on service with Dr. Bagg.  Dr. Bagg will also perform microsurgical reconstruction of lower limb and upper limb soft tissue defects.  The fellow will gain confidence with the anatomy of the upper extremity given the wide variety of procedures performed on the upper extremity (from fingertip to shoulder) on this rotation.  In addition, a half day will be committed to research and academic activities.

Sample cases include:
Mini open carpal tunnel releases, thumb CMC trapeziectomy with LRTI, total elbow arthroplasty, total and reverse shoulder arthroplasty, rotator cuff repair, DRUJ reconstruction, thumb UCL repair and reconstruction, ORIF distal radius, CRPP and ORIF metacarpal fractures, lateral epicondyle release, ORIF olecranon fracture, ORIF humerus fracture (distal, shaft, and proximal), vascularized bone grafting of scaphoid nonunions with medial femoral condyle, opponensplasty.

Dr. Person's Rotation.  You will spend an average of 2.5 days in the OR and 2.5 days in clinic.  You will be exposed to a wide variety of cases, ranging from the common to the exquisitely complex.  You can expect to add considerably to your skill set in the evaluation and surgical treatment of complex problems.  Dr. Person sees both pediatric and adult patients and performs a variety of surgical procedures, ranging from “typical” elective hand surgery cases to complex microvascular reconstruction of head and neck defects after radical tumor resection performed by the ENT surgeons who consult his expertise.

Sample cases include:
Endoscopic carpal tunnel release, trapeziectomy with APL suspensionplasty, radial forearm free flap, pectoralis rotational flap, 1st web space contracture release, ORIF distal radius and other hand fractures, trigger releases, syndactyly release, reconstruction of duplicated thumbs, pollicization.

Dr. Srinivasan, Dr. Dutta, Dr. Morrey, Dr. Wirth and Dr. Cromack’s Rotation.  A true “flex rotation”, the hand and upper extremity surgery fellow will spend time with both Dr. Srinivasan and Dr. Dutta during this rotation in scheduled fashion, sharing time between the Hand Center and the University (UTHSCSA).  In addition to that, the fellows have the opportunity to work with Drs.  Morrey, Wirth and Cromack depending on interest and time available on the fellows’ part.  The hand surgery fellow will be exposed to a wide variety of techniques in the care of upper extremity conditions.  The fellow can expect to see a wide range of conditions, from the simple to the complex.  In addition, Dr. Srinivasan has taken over the brachial plexus clinic, which was led in the past by Dr. Pederson, giving hand surgery fellows exposure to brachial plexus injuries.

Sample cases include:  

Elbow and wrist arthroscopy, ORIF wrist fracture, shoulder arthroscopy (including sad, dce, rcr, capsular release), ulnar shortening osteotomy, open and endoscopic carpal tunnel release, thumb CMC trapeziectomy with LRTI, elbow arthrotomy and contracture release, total elbow arthroplasty, total and reverse shoulder arthroplasty, rotator cuff repair, DRUJ reconstruction, thumb UCL repair and reconstruction, CRPP and ORIF metacarpal and phalangeal fractures, lateral epicondyle release, ORIF olecranon fracture, ORIF humerus fracture (distal, shaft, and proximal), vascularized free fibula reconstruction of nonunion, brachial plexus injuries.