The OHSU Hand Fellowship is one of only a few hand surgery fellowships in the country that truly integrates both Orthopedic and Plastic Surgery approaches to the diagnosis and treatment of upper extremity problems. The fellowship has been in existence since 1995, under the auspices of the Division of Plastic Surgery and is accredited by the ACGME. Fellows have always had in depth exposure to common hand surgery procedures with emphasis on reconstruction, microsurgery, and pediatric hand surgery under the supervision of upper extremity surgeons in both Plastic Surgery and Orthopedics. In the recent past, our fellowship applicants have sought increased exposure to orthopedic upper extremity surgery – particularly as it relates to the elbow and the shoulder. In response to this need, we continue to broaden the scope of our fellowship. The fellowship is also transitioning to having co-directors from both orthopedic and plastic surgery.
The core of any hand fellowship is its clinical program. At OHSU, a broad array of upper extremity problems is managed by leaders in the field. As one of only two Level I trauma centers in the state, OHSU is a major referral center for replantation and complex upper extremity reconstruction for Oregon, Southern Washington, Northern California, and Idaho. The fellow's exposure to upper extremity cases is further augmented by several affiliated institutions that are all located on the OHSU hilltop campus including a busy Veterans Hospital, Doernbecher Childrens Hospital, and Portland Shriner's hospital. OHSU is also home to one of the nation's few multidisciplinary brachial plexus and peripheral nerve centers so that the fellow can acquire skills in nerve repair, nerve grafting, nerve transfers, tendon transfers, and free muscle transfers.
The centerpiece of the fellowship's didactic program is the weekly hand surgery conference. The conference is attended by the orthopedic and plastic surgery residents, the program faculty, and community hand surgeons and hand therapists. The curriculum covers the breadth of hand surgery. Conference topics are presented by the hand fellow, the residents, the program faculty, and invited guest experts. Presenters can avail themselves of a library of powerpoint presentations covering all major topic s in hand surgery. Several other special conferences also take place during this same time period, including cadaver prosections, journal clubs, and case presentations. Formal didactic and practical instruction in microsurgery technique in the microsurgery laboratory.
Fellows are encouraged to participate in research activities during their training. The abundant clinical material allows for variety of projects. In addition, biomechanics projects are supervised by the Department of Orthopedics and by the hand surgery faculty at the VA Medical Center.