The Hand Center
The Hand Center is the direct lineage of the office of Dr. Paul Swett, one of the oldest orthopaedic practices in the United States dating back to 1918. It is also the center of one of the oldest continuous hand fellowship training programs dating back to 1969.
Offices of the private practice of Drs. Watson, Ashmead, and Mastella, The Hand Center provides the core experience in office based ambulatory care. Fellows work side by side with hand fellowship faculty in one to one assignments, evaluating new out-patient consultations, developing differential diagnoses, treatment plans and seeing those same patients for follow-up to assess their response to conservative and/or surgical management. In office diagnostic facilities include x-ray and neurometrix. An onsite hand therapy practice affords a unique opportunity for collaborating with certified hand therapists, both in the conservative management of hand pathology, and in rehabilitative efforts including occupational therapy. Fellows are directly supervised by fellowship faculty at The Hand Center.
Glastonbury Surgery Center
The Glastonbury Surgery Center provides the bulk of experience in outpatient/ambulatory hand surgery. Fellows participate in reconstructive surgical procedures scheduled by hand surgical faculty in that setting. Fellows become versed with appropriate patient selection for surgery in a free standing facility, and the unique challenges of immediate postoperative care and discharge planning in that setting. Fellows are supervised one to one by the hand surgical attending of record for each case.
Hartford Hospital provides the core experience in hospital based hand surgery including an inpatient hand surgery service. This is run by the hand fellows, supervising junior residents rotating on the hand/plastic surgery service. Hand fellows are in turn supervised by the specific attending of record for each patient. Hand fellows are responsible for responding to inpatient consultation requests from internal medicine, trauma, orthopaedics and other inpatient services. In addition to inpatient surgical procedures, hand fellowship faculty and hand fellows perform outpatient surgical procedures in the Hartford Hospital day surgery unit.
The Hartford Hospital ER provides the core experience in adult trauma and the management of acute acquired conditions including infection. Hand fellows respond to ER consultation requests, supervising the junior residents and physician assistants on the hand/plastic service, and in turn supervised by the on-call hand surgical attending of record for each patient.
The Hartford Hospital Hand Clinic provides vital experience in office based ambulatory care for a patient population which is ethnically, educationally and economically diverse and frequently challenged. Hand fellows assume primary clinical responsibility in the hand clinic setting, supervising junior orthopaedic residents in the evaluation and management of patients. Hand fellows bear primary responsibility for diagnostic evaluation, elaboration of a treatment plan, later implemented by the fellow and/or resident in collaboration with a responsible hand surgical attending. The Hand Clinic provides an essential opportunity for fellows to take on graded responsibility over the course of the fellowship year. The Hartford Hospital Hand Clinic is supervised by hand fellowship faculty on a weekly rotating basis.
Connecticut Children’s provides an additional experience in hospital based care, specific to a patient population under eighteen years of age. Once again, hand fellows assume primary responsibility for inpatient and consult services, respond to ER consultation requests, and participate in in-patient hand surgical procedures derived from those services. In addition, Connecticut Children’s has an out-patient surgery department. Connecticut Children's provides hand fellows with exposure to a range of surgical pathology which is unique to the pediatric patient population including congenital and developmental conditions, fracture patterns in immature bones and instances of child abuse. In addition, fellows become well versed with the particular challenges of gathering an appropriate history and physical examination from a patient population which may not be able or inclined to communicate or cooperate with the process. There are also unique challenges entailed in collaborating with parents in the care of their children. Hand fellows much coordinate care with the inpatient pediatric service which follows all admitted patients. The hand fellows are supervised by the attending hand surgeon of record for each individual patient.