Updates from the March 2016 American Society for Surgery of the Hand (ASSH) Touching Hands Project mission trip to San Pedro Sula, Honduras



Touching Hands Project – March 2016 – included 7 members of the Duke Medical Community: 2 members from Duke Orthopaedics, 2 members from the Duke Hand Therapy staff, and 3 from the Duke anesthesiology team.


The THP team visited 2 orphanages and one school in San Pedro Sula. They enjoyed reading and serving dinner at the girls’ home, and playing in a competitive soccer match at the boys’ orphanage.

This trip to Honduras was comprised of a special group that bonded from the outset and we enjoyed many special memories together; from the busy Sunday clinic seeing over 120 patients, to our community visits that included two orphanages, the inspirational Motivo School, an educational session by our therapists for Genesis Apparel, a tour of Elcatex and Francis/SanMar – and, of course, a week filled with incredible experiences in the operating room.

Drs Fraser Leversedge (left) and Katie Faust (right) from Duke Orthopaedics perform an arthrodesis for a post-traumatic deformity of a finger PIP joint.


The THP brigade, the second to the Ruth Paz Hospital and Clinic in San Pedro Sula, Honduras, performed 51 cases from Monday to Friday.

THP – Team Honduras included members of several institutions and was comprised of 3 attending hand surgeons, 3 hand surgery fellows, 2 hand therapists, 3 anesthesia staff, 1 pediatrician, and 2 nurses. The team included: Drs. Fraser and Kimberly Leversedge (Duke University), Dr. Julia Katarincic (Brown University), Dr. Anthony Smith (Mayo Clinic – Scottsdale), Dr. Andrea Halim (Brown University), Dr. Katherine Faust (Duke University), Dr. Peter Letourneau (University of Louisville), Julie Lunich, CHT, OTR/L (Duke University), Christine Khelfa, CHT, OTR/L (Duke University), Dr. Marcy Tucker (Duke University), Dr. Sid Sata (Duke University), Donald Moede, CRNA (Duke University), Melissa Reavie, RN (Mayo Clinic – Scottsdale), and Sarah Prunuske, RN (Mayo Clinic – Scottsdale).

Many cases were complex in nature, involving chronic tendon, nerve, and fracture related injuries and congenital reconstruction cases. In all, the team performed approximately 122 primary-type procedures in adults and children including:

  • Birth brachial plexus tendon transfers (4)

    Dr Katie Faust, one of the Duke Orthopaedic Surgery Hand Fellows performs a radial to axillary nerve transfer for a patient with a brachial plexus injury

    Dr Katie Faust, one of the Duke Orthopaedic Surgery Hand Fellows performs a radial to axillary nerve transfer for a patient with a brachial plexus injury

  • Adult brachial plexus related nerve transfers (4)
  • Major nerve repair (5)
  • Nerve reconstruction/grafting (4)
  • Neurolysis (1)
  • Joint contracture releases (9)
  • Extensor tendon repair or grafting (12)
  • Extensor tendon transfers (4)
  • Extensor tenolysis (4)
  • Flexor tendon repair (12)
  • Flexor tendon reconstruction/grafting/transfer (20)
  • Flexor tenolysis (5)
  • Flexor pulley reconstruction (3)
  • Digital joint arthrodesis (3)
  • Carpal tunnel release (4)
  • Ulnar nerve anterior transposition (1)

    Members of the Duke Anesthesia team (left to right): Don Moede, CRNA, Sid Sata, DO, and Marcy Tucker, MD, prepare to perform a regional block on a patient scheduled for tendon reconstruction surgery.

  • Proximal row carpectomy (2)
  • Total wrist arthrodesis (2)
  • Darrach procedure (1)
  • Wound irrigation/debridement for chronic wound infection (4)
  • Skin grafting (4)
  • Dorsal wrist ganglion cyst excision (2)
  • Excision biopsy of forearm mass (1)
  • Fracture repair – ORIF (3)
  • Fracture repair – percutaneous pinning (3)
  • Congenital hand/pediatric hand:
    • Lateral condyle malunion and elbow instability (1)
    • Syndactyly reconstruction – simple (1)
    • Syndactyly reconstruction – complex (1)
    • Apert’s reconstruction (1)
    • Proteus Syndrome / macrodactyly reconstruction (1)
    • Polydactyly reconstruction (2)

Above: The THP team performed complex thumb and index finger deletion, debulking, and middle finger pollicization in this young girl with Proteus Syndrome.

We leave Honduras happily exhausted from a memorable week of experiences that have touched our hearts and our emotions, have inspired us, and have taught us to make the most of our opportunities. We are excited to return soon.

Fraser J. Leversedge, MD

To read more about the March 2016 Touching Hand Project in Honduras, please click here.

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