Scaphoid fractures are commonly encountered injuries in orthopaedic surgery. Accurate diagnosis and appropriate management are crucial to ensure healing and to avoid development of scaphoid non-union advanced collapse.
In this session badged by the BSSH we provide a comprehensive review of scaphoid fractures. We will review scaphoid anatomy and carpal biomechanics and outline the optimal way of diagnosing suspected fractures. We then review the latest evidence about treatment of scaphoid fractures and discuss the landmark SWIFTT trial. This session will then review the surgical management of scaphoid fractures and non-unions and discuss controverises.
Chair: Kalpesh Vaghela & Rob Poulter
Agenda:
14:45 - 15:00 Aanchal Jain, Consultant Hand & Wrist Surgeon, Epsom & St Helier
Scaphoid Anatomy and Biomechanics
15:00 - 15:15 Ben Dean, Consultant Hand & Wrist Surgeon, Oxford University Hospitals NHS Trust
Diagnosis of Suspected Scaphoid Fractures
15:15 - 15:30 Nick Johnson, Consultant Hand and Wrist Surgeon
Evidence-Based Treatment of Scaphoid Fractures (SWIFFT trial)
15:30 - 15:45 Greg Pickering, Consultant Hand & Orthopaedic Surgeon, The Royal United Hospitals Bath NHS Foundation Trust
How to Fix a Scaphoid Fracture
15:45 - 16:00: Nicola Fine, Consultant Orthopaedic Hand & Wrist Surgeon, Royal Devon and Exeter Hospital
Treatment of Scaphoid Non-Unions and Salvage Options
16:00 - 16:15 Q&A Panel Discussion
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Kalpesh Vaghela
Consultant Hand & Wrist Surgeon, Royal London Hospital, Barts Health NHS Trust
Kalpesh is a Consultant Trauma & Orthopaedic Surgeon with a specialist interest in Hand & Wrist Surgery based at the Royal London Hospital, Barts Health NHS Trust.
Kalpesh read medicine at Imperial College London and completed a BSc in Surgical Sciences graduating with 1st class honours. He completed specialist orthopaedic training on the prestigious Percivall Pott rotation. Kalpesh then undertook the Training Interface Group (TIG) integrated orthoplastics hand surgery fellowship at the Pulvertaft Hand Centre, Derby and gained international experience at the world-renowned Royal North Shore Hospital, Sydney, Australia. He has been awarded the BSSH Travelling fellowship attending the Institute Kaplan in Barcelona, Spain and the ASSH International Fellowship to attend centres of excellence in the USA learning from some of the world's pioneering surgeons.
Kalpesh has obtained dual diploma qualification in hand surgery completing both the European and British diplomas the latter of which he was awarded the Vivien Lees Gold Medal. He has completed an MSc in Medical Education at UCL and was awarded the Robert Jones Medal & Association Prize by the BOA.
His main interests are medical education, trauma and wrist arthroscopy.
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Rob Poulter
Consultant Hand & Wrist Surgeon, Royal Cornwall Hospitals NHS Trust
Mr. Rob Poulter is a Consultant Orthopaedic Surgeon with a decade of experience in the treatment of hand and wrist conditions that impact bony and soft tissues, including carpal tunnel syndrome, Dupuytren's contracture, skin cancer, and entrapment. He sees private patients at the Ramsay Health Duchy Hospital.
Mr. Poulter graduated from the Royal Free Hospital, School of Medicine, and went on to undertake his basic and specialist orthopaedic training in the Southwest of England. He later gained the opportunity to undertake various sought-after national and international hand and peripheral nerve fellowships, in Nottingham, Melbourne, and Sydney.
Since his Consultant appointment in 2011, Mr. Poulter has centred his practice around clearly communicating with his patients and his colleagues, to ensure patients receive an excellent standard of care from the team, as a whole. He is also actively involved in the medical education community, teaching national hand surgery courses and working as an academic tutor for medical students at the University of Exeter.
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Nick Johnson
Consultant Hand and Wrist Surgeon
Mr Nick Johnson graduated from the University of Leicester in 2005. He underwent his higher surgical training in the East Midlands South region before obtaining his FRCS (Tr&Orth) in 2014. Following a Fellowship at the Pulvertaft Hand Centre, he was appointed as a Consultant Hand and Wrist Surgeon at Derby in 2019.
Mr Johnson has a strong interest in research and teaching and completed a PhD about wrist fracture epidemiology during his higher surgical training along with a Postgraduate Certificate in Education. He has published many scientific papers and several textbook chapters, supervises students carrying out research degrees and has been involved with writing national guidance for wrist fracture treatment.
His main clinical and research interests include hand trauma epidemiology and prevention, improving outcome after hand trauma and the treatment of Dupuytrens disease
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Nicola Fine
Consultant Orthopaedic Hand & Wrist Surgeon, Royal Devon and Exeter Hospital
Nicola is a consultant orthopaedic hand surgeon at the Royal Devon and Exeter Hospital. She completed her medical degree at Bristol University, going onto core and higher surgical training in the South West Peninsula Deanery. She passed her FRCS in 2018 and won the Sir Walter Mercer gold medal. Following registrar training she completed a TIG fellowship in Swansea and an International fellowship in Melbourne both in orthoplastic hand surgery. She has completed the British Hand Diploma and is now a tutor for this. She is part of an orthoplastic hand unit, practicing in all aspects of hand surgery but with specialist interest in arthritis and is part of the tertiary referral centre for total wrist replacements in the Southwest.
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Greg Pickering
Consultant Hand & Orthopaedic Surgeon, The Royal United Hospitals Bath NHS Foundation Trust
Greg Pickering is a Consultant Hand & Orthopaedic Surgeon at The Royal United Hospitals Bath NHS Foundation Trust, including at the National Hospital for Rheumatic Diseases.
Mr Pickering completed his higher specialist training in Trauma & Orthopaedics on the Severn (Bristol) Rotation, followed by a National Training Interface Group Fellowship in Hand Surgery at the Queen Elizabeth Hospital and the Royal Orthopaedic Hospital in Birmingham. Mr Pickering was the British Delegate to the American Society for Surgery of the Hand International Travelling Fellowship, a BSSH delegate to the BOA Future Leaders Programme, and has completed the British Diploma in Hand Surgery. Mr Pickering has a particular interest in medical education, and has multiple formal qualifications in this field. He regularly develops and delivers cadaveric surgical training courses, is a sitting member of the BSSH Education Committee, as well as being Specialty Tutor and a named supervisor and trainer of future orthopaedic and hand surgeons.
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Aanchal Jain
Consultant Hand & Wrist Surgeon, Epsom & St Hellier
Aanchal Jain is a dual fellowship trained Consultant Hand and Wrist Surgeon at King’s College Hospital NHS Foundation Trust, with extensive subspecialty training in hand, wrist and upper limb surgery. After graduating with distinction from Imperial College London, Aanchal obtained her BSc in Management and Medical Sciences with First Class Honours. She completed higher surgical training in Trauma and Orthopaedics across major London teaching hospitals. She went on to complete prestigious Hand Fellowships at both the Pulvertaft Hand Unit in Derby and Queens Medical Centre in Nottingham, gaining expertise in complex trauma, reconstructive, and wrist arthroscopy procedures. Her clinical practice encompasses the full spectrum of hand and wrist pathology, including trauma, degenerative and inflammatory conditions.
A passionate educator, Aanchal has a substantial teaching portfolio. She serves as faculty on national and regional FRCS preparation courses and registrar training sessions across the UK. She has set up highly successful pan-London courses for trainees and has organised registrar teaching programmes, mock viva exams and cadaveric workshops. Aanchal has also written multiple book chapters, published in peer-reviewed journals and presented nationally and internationally receiving numerous prizes for her work.
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Ben Dean
Consultant Hand & Wrist Surgeon, Oxford University Hospitals NHS Trust
Ben is a consultant orthopaedic hand surgeon at Oxford University Hospitals NHS Trust and a senior research fellow at the University of Oxford. His research interests include carpal trauma, hand osteoarthritis, implementation and collaborative projects.
