Welcome to the 9th annual Manus Club meeting, this year held in beautiful Green Lake, WI. The lake is about a 2 hour drive northwest of Milwaukee, and can be seen in the top left corner of the map below.
The meeting was held at the Heidel House resort on the north shore of the lake. It looks
just like this!
Present at this year's meeting were President Jon Tueting, Rob Kaufmann, Milan Patel, Randy Alexander, Dan Zlotolow, Becky Yu, and newcomers Sanj Kakar, Jeff Friedrich, Ryan Calfee, and Peter Hoepfner. Despite a last-minute drop-off in attendance, we had a fun, eduational and enriching meeting. Many many thanks to our generous hosts Jon and Sarah!
I managed to miss the meeting on Thursday morning due to a small medical emergency on the first leg of my trip into Milwaukee. All is well, thankfully, and I think I have managed to capture all that was discussed on the first day in this blog. If not, please fill me in!
Business items reviewed on all 3 days of the meeting:
- We are at 29 members, with a cap of 30.
- To stay an active member, you must attend a meeting every 3 years
- If you do not attend a meeting every 3 years, the membership votes on whether you stay in, and you lose voting rights until you again reach active status.
- Dues must be maintained in order to remain active.
- The membership selection process was reviewed: new member nominated, discussed among those present, name sent out to all members. If no veto, the person is invited to meet the group at the next ASSH dinner/drinks event. If no veto, the person is invited to come to the next meeting.
- New member nominations this year: Don Bae and Marc Richard. They will be invited to drinks in Seattle.
- Yes, 2 nominations, which brings our total to 31. Which means 1 member will need to be voted off the island. There are a number of members who have not met the requirements to maintain their active status. Or, do we make an exception, and allow the membership to go to 31 temporarily. Discuss.
After the meeting on Thursday, our members and their kids gathered on the Escapade for a cruise around the lake with commentary by Captain Dennis, who knows everything there is to know about the lake. It started to rain, but that didn't keep the kids from running up and down the stairs.
(Meanwhile, there was a gathering at the spa for the better halves...)
After the cruise we all gathered at Christiano's for pizza. Because of the weather, we were unable to enjoy the patio that Jon and Sarah had reserved for us. Once again, a little rain would not deter our crew! The number of Manus kids has exploded!
On the second day of the meeting, we conducted a validation lab for new distal radius plates by Osteomed. Advantages of the plates: more length options, width options, column specific plates, cannulated locking screws, universal screw holes, and variable angle locking screws. Designed by our very own Dan Z., Ray, and Jon (did I get that right?). A number of suggestions were made. Unfortunately, we did not have time afterward to make more use of the cadaver arms. Note for future labs...
We have been asked by the ASSH if we would like to head up a Touching Hands volunteer site. This would be organized by us, staffed by us (if we want) once or more each year. Funding will come from the Touching Hands project, so we will not need to do any fund-raising. Of note, several years ago, the idea of volunteerism was not looked upon favorably within our group, so we should probably discuss this idea with the membership, maybe over drinks in Seattle. In any case, there was a suggestion of Cuba as our preferred destination for many reasons including proximity (as opposed to, say, an African country), interest for families, etc. Dan Z., Becky, and Randy were selected to head up a scouting team to investigate the feasibility of such a project. More to come. Any input is welcome.
After the meeting we all gathered at the pool for some R&R.
And took advantage of the beautiful day with rides on waverunners...
...and paddle boards.
There was an outdoor party that evening complete with live music, supplemented by the musical talents of our own Randy and Jon. We even have a theme song now!
Before the sun got too low, we managed to coerce most of our party to gather on the beach for some group photos.
Although, some had had enough of the group thing by then.
Saturday morning we heard from Jeff F. on a case series involving injuries to the ring and small fingers, for which he transferred the ring to the small finger - salvaging the good parts of each digit. We also saw a follow-up video from Dan Z. of his bilateral hand transplant, at the time, 2 weeks out from surgery, with what appears to be good motion. The surgery was reported
in the news and in multiple media outlets. Congratulations, Dan!
We then finished up our Tsunami presentations. I didn't really notice what was actually written on this slide until I went through all my photos. But I may use this to introduce the Tsunami presentations from now on!
Entrants:
- Randy: 43yo athlete with OCD. Biceps tenodesis revision with biceps button. IV abx for P. acnes. Retear/partial tear of muscle (Jon: screen for MRSA/MSSA. sage cloth 1 hour before. Vanco, cefuroxime, bactroban, chlorhexidine)
- Rob: 50 yo normal woman with comminuted DRF. Dorsal plate and pins. pin tract infection. Pins out, IV abx. Wound dehiscence. Plate out. ABX spacer. Crooked wrist, but happy patient!
- Becky: 75 yo diabetic smoker s/p bil LE amputations. Index finger necrosis. Multiple surgeries. Wound healing issue. Finally healing with sugar dressings.
- Sanj: fragment specific plates. 53 yo open DRF and ulna fx. Ex fix outside institution. Valor cortex shatters while tapping in pin plate. Fell apart. Femoral head allograft. Central third with wrist fusion. (Jeff: spanning plate. Synthes or Trimed. Span to index finger metacarpal) Instead: skeletal dynamics hook plate instead of Trimed.
- Jon: forearm fracture, CMC dislocation, multiple fractures. Didn’t heal, plate broke. 90/90 plating. Healed.
- Jeff: 57 yo woman. Don’t ever run for the bus! Ring finger P2 fx. Hemi-pilon Pt declined surgery. Buddy-taped. 3.5 weeks later, pain, limited ROM. Wants surgery. Incision over wrong finger.
- Dan: Level 10 gymnast. OCD right elbow. 2 years of pain (starting age 8). Loose body. OATS from femoral condyle (7mm core from elbow, 8mm core from knee, press fit). Becomes Elite gymnast. 18 months pain free. Left wrist swelling and pain. Epiphysitis. Casted 8 weeks. Physis filled in. Elbow pain again. OATS cartilage flap came loose. Scope, debrided, micro-fracture. Done with gymnastics. Now elite diver.
- Peter: 70 yo fell down stairs. Distal humerus fracture - comminuted, bony defect posteriorly. ORIF through olecranon osteotomy. Fell before 1st post-op. Long oblique fracture of humeral shaft through screw holes. Joint surface intact. Wound - erythema. Posterolateral plate. 6 weeks post-op doing well. 5 mos post-op, pain with rotation. Resorption of lateral column. Catching with rotation. Radial head resection. Cut off distal part of lateral plate. Still with pain, but good motion.
- Milan: carpal tunnel post-op infection. (Reminiscent of the 2012 Tsunami award-winning case!) 4 weeks ABX. Closed eventually.
And the winner is...
Peter!
To close out the meeting, we heard nominations for next year's meeting. The nominees were:
- A dude ranch (Arizona, Colorado, Wyoming, etc)
- Florida panhandle
- Puerto Rico
- Bar Harbour
- Roche Harbour/San Juan Islands
- Jackson Hole
Traditionally, s/he who nominates the winning location becomes the president for the next year, advised by this year's president. However, this year, given that 4 of the 10 attendees were first-timers, and 5 of the remaining attendees had already served a term as president, it was decided even before the nominations were made, that Milan would serve as our next President. Congratulations Milan!
The vote came to a virtual tie between the Dude ranch and Puerto Rico. Dan Z. thoughtfully asked, "Milan, would you be willing to do a dude?" Which brought a flush to Milan's face. Dan Z. then pointed out that he had already turned down Jackson Hole. Which elicited an "Ummm..." from Milan, who then quickly decided that we would be going to Puerto Rico.
This is the proposed location:
http://www.wyndhamriomar.com/ The Wyndham Grand, Rio Mar Beach Resort and Spa. It is about an hour's drive from San Juan, and across the street from El Yunque rain forest.
The dates for next year's meeting are
July 7 -9, 2016 (Thurs - Sat).
July 4 is the Monday before the meeting. There has been talk of taking the whole week, and spending 2-3 nights in San Juan before driving out to the resort. Just a thought - but sounds good to me!
At the conclusion of the meeting, Jon took us all out on his boat for some tubing and swimming and general touring of the lake.
On our last night at the lake, those of us who were still there (tried to) put our kids in a room with a handful of babysitters, then got dressed up for a grown-up dinner at Grey Rock Mansion. It was nearly a success! A few of us even managed to make it out one more time to the Boathouse for a final drink before saying good bye. (Sorry, but does the guy on the far left look a little dark in this picture?)
Thanks, everyone, for another superb meeting! A reminder to all: please make use of the Manus google drive. The drive has a lot of potential use for us on professional and social levels. Please update your own information on the family roster. We will be creating a Manus Social listserv, so if there is anyone other than yourself that you would like to add to the list, please make sure Milan has that information, which can be added to the spreadsheet.
I hope all who attended, members and families, had an easy trip home. And I hope this encourages all others to try to make it to Puerto Rico!
Coming up next:
Videos from Green Lake
Words from your presidents
Your Secretary, Becky
Out.
