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/!\ All times are in Paris Time

8:30 // Introduction

Spasticity: an update / J.M Gracies (France)

9:00 // Evaluation: what does the surgeon need?

International Classification of Functioning, Disability and Health (ICF) / C. Colborne (UK)
SHUUE / D. Weigl (Israel)
MUUL / C. Colborne (UK)
AHA / E. Chaleat-Valayer (France), R. Bard (France)
MACS / H. Gong (Korea)
GAS / F. Coroian, I. Laffont (France)
COPM / M. Lewis (Australia)
Sensory deficit / A. Van Heest (USA)
The role of video / EMG analysis / A. Van Heest (USA)
Functional assessment in children with hemiplegia: a surgical perspective / C. Parot (Chile)
Pre-operative assessment in the brain-injury patient: detecting «hidden functions» / D. Gasq, C. Villepinte (France)
Debate // The ideal surgical assessment / E. Chaleat-Valayer (France), C. Colborne (UK), B. Coulet (France), I. Laffont (France), C. Parot (Chile), A. Van Heest (USA)

10:10 // Clinical examination

Key points of clinical examination / C. Vuillermin (USA)
Patient examination / M. Tonkin (Australia)
Attempted surgical classification of spastic upper limbs / B. Coulet (France)

10:40-11:10 // Break

11:10 // Non-surgical treatments

Botulinum toxin and surgery
- Botulinum toxin and surgery / S. Kocer (Switzerland)
- Complications and so-called “failures” / E. Cosentino (Italy)

11:30 // Decision making: Goals, strategy and timing -
When to refer the patient to the surgeon?

In children: C. Colborne (UK) / Discussor M. Ezaki (USA)
In adult: I. Laffont (France) / Discussor C. Gschwind (Australia), F. Lapierre (France)
Contra-indications to surgery / M. Ezaki (USA)

12:30 // Neurosurgical treatment

Moderator: P. Mertens (France)

Intrathecal baclofen and dorsal selective radicotomy / C. d’Hardemare (France)
Intrathecal baclofen therapy in children: special considerations / C. Hagemann (Germany)

13:00-14h:00 // Break

14:00 // Invited lecture

Fifty years’ experience of surgery of the spastic upper limb: evolution of my practice / Y. Allieu (France)

14:20 // Surgical techniques

“Multiple Fasciotomies: the shark attack”
- Technique and indications / M. Poschmann (Germany)
Comment / M. Kreulen (Netherlands)

14:40 // Partial neurectomies

Moderator : F. Lapierre (France)

Mechanism of action and evolution / P. Mertens (France), J. Maarravi (Lebanon)
Technique of selective neurectomy and results / P. Mertens (France)
Hyperselective neurectomy
- Anatomical basis / A. Cambon-Binder (France), C. Parot (Chile), R. Paulos (Brazil)
- Technique video / M. Gras (France)
- Results / C. Leclercq (France)

15:30 // Tendon transfers

Moderator : S. Kozin (USA)

Tendon transfer surgery Vs Botox Vs regular ongoing therapy / A. Van Heest (USA)
Characteristics of the spastic muscle and biomechanics of tendon transfers in the spastic patient /M. Kreulen (Netherlands)
Choice of donor muscle / A. Lovic (Spain)
Why tendon transfers in the growing child are unpredictable / E. Ponten (Sweden)

16:20-16:50 // Break

16:50 // Invited lecture

Movement disorders / M. Ezaki (USA)

17:05 // Indications and Results

Shoulder lengthening / P. Zerbinati (Italy)
Shoulder neurectomy / F. Fitoussi (France)
Articular procedures: suspension, arthroplasty / B. Coulet (France)
Influence of shoulder surgery on distal function / B. Coulet (France)
Clinical cases // M. Ezaki (USA)

18:00 // End of scientific programme

8:00 // Elbow

Technique of elbow release / S. Kozin (USA)
The role of the biceps / S. Pickard (UK)
Partial release: fractional lengthening of the biceps / H. Gong (Korea)
Lengthening and neurectomies / P. Panciera (Italy)
Anterior release and self-esteem / F. Soldado (Spain)
Clinical case // Elbow dislocation due to movement disorders / W. Girsch (Austria)

8:50 // Pro-supination

Moderator: M. Kreulen (Netherlands)

The forearm: the forgotten joint / S. Kozin (USA)
Classifciation and indications / C. Gschwind (Australia)
Release of pronation / T. Ozkan (Turkey)
Pronator rerouting / A. Van Heest (USA)
Augmenting supination: the brachioradialis transfer / T. Ozkan (Turkey)
One bone forearm for fixed supination contracture: An easy solution / S. Kozin (USA)
Debate // how to avoid hypercorrection? A. Van Heest (USA), M. Kreulen (Netherlands), C. Gschwind (Australia), S. Kozin (USA)

// Wrist and fingers

9:40 // Lengthening

Medial epicondylar release and Scaglietti-Page / B. Coulet (France)
Flexor - pronator aponeurectomy / M. Tonkin (Australia), C. Leclercq (France)
Fractional lengthening: anatomical basis / A. Arnaout (France)
Fractional lengthening: surgical technique / M. Kreulen (Netherlands)

Debate // Scaglietti- Page / B. Coulet (France)
vs Fractional lengthening / M. Kreulen (Netherlands)
STP transfer: technique, indications and complications / B. Coulet (France)
Alternative to STP: tenotomy-lengthening / A. Geffrier, P. Denormandie (France)

10:45-11:15 // Break

11:15 // Restoring the balance: tendon transfers

Assessment of FCU function for tendon transfer surgery / M. Kreulen (Netherlands)
Analysis of the FCU firing pattern before and after tendon transfer surgery / A. Van Heest (USA)
Why I no longer transfer the spastic FCU / S. Kozin (USA)
ECU to ECRB - preferred approach / S. Kozin (USA)
What to do when tendon transfers don’t turn out the way you expected ? / E. Ponten (Sweden)
Debate // Transfer or not transfer ? Which donor muscle? / M. Ezaki (USA), S. Kozin (USA), M. Kreulen (Netherlands), A. Lovic (Spain), A. Van Heest (USA)

11:50 // Wrist arthrodesis

Moderator : S. Hovius (Netherlands)

Technique / S. Kozin (USA)
Indications and results / A. Van Heest (USA)
Wrist arthrodesis in adolescents / F. Fitoussi (France)
Partial wrist arthrodesis / C. Parot (Chile)
Impact of wrist arthrodesis on proximal function / B. Coulet (France)
Kienbock and Spasticity / W. Girsch, G. Weigel (Austria)
Discussion // Arguments against wrist arthrodesis - comment / M. Kreulen (Netherlands)

12:35 // Clinical cases

13:00-14:00 // Break

14:00 // Thumb

Classification of thumb deformities / C. Gschwind (Australia)
First web release: techniques / M. Kreulen (Netherlands)
Alternative technique 1st web approach / M. Gras (France)
Hyperselective neurectomy of the first web muscles: preliminary results / N. Bini (Italy)
EPL rerouting / M. Kreulen (Netherlands)
Thumb MPj instability: capsulodesis / M. Kreulen (Netherlands)
vs sesamoido-metacarpal arthrodesis ?
Thumb in palm: get rid of a joint! / S. Kozin (USA)
Dynamic thumb-in-palm. Temporary transarticular pinning to assess definitive joint fusion / F. Soldado (Spain)

14:50 // Fingers

Anatomy of the interosseous muscles / C. Fontaine, N. Nachef (France)
How do we assess the intrinsic muscles? / C. Gschwind (Australia)
Intrinsic release: technique and postoperative management / L. Gatin, P. Denormandie (France)
Feasibility of percutaneous release of the interosseous muscles / N. Nachef, C. Fontaine (France)
Swan-neck: lateral band rerouting: technique / M. Kreulen (Netherlands)
: central slip tenotomy ?
Boutonnière deformities ?
Debate // Clinical cases

15:30 // Tetraplegia and spasticity

Classification / Y. Allieu (France)
Treatment / C. Reinhold (Sweden)

15:40-16:00 // Break

16:20 // Severe spasticity

The Mini-Hand-Score / S. Facca (France)
Management of severe deformities: finger flexor tenotomies at the bedside / A. Geffrier, L. Gatin, P. Denormandie (France)
Hopeless cases: beyond surgery? / S. Hovius (Netherlands)
Improvement in the career burden score after surgery for severe spasticity / C. Gschwind (Australia)

17:00 // Misc

The hand in Parkinson’s disease / N. Nachef (France)
Spastic missions in developing countries: interview / S. Kozin (USA), S. Gallego (Columbia)

17:20 // The future

Brain stimulation / S. James (France)
Nerve transfers ? /

17:45 // End of the Symposium