The Indiana Hand to Shoulder Center was founded with the vision of delivering the highest quality patient care, providing the most respected postgraduate upper extremity training, and maintaining a work environment that provides excellence. The Indiana Hand to Shoulder Center’s mission is to be the premier provider, educator and innovator in the prevention and treatment of upper extremity disorders. 


A letter to our potential fellowship applicants:

The formal education of a hand surgeon is a daunting task; the field is enormous, ranging from the fingertips, across the wrist, elbow, and shoulder joints, to the brachial plexus, bringing together all aspects of orthopedic, neurosurgery, vascular surgery, and plastic surgery into this single, extremely important area of the body. We believe that the experience a fellow receives during their very short 12-month training period is best supplied through a multifaceted approach, involving a group of diverse, committed educators with varying specialty interests and expertise. The crucial nature of this one year of fellowship training cannot be overstated – it will be the most important year of education for your career!

The Indiana Hand to Shoulder Center and its physician partners have been educating fellows for nearly 50 years. We believe strongly the best post-residency training in hand surgery is provided from a private practice base. Each hand fellow begins his/her year of postgraduate training not as PGY-6 resident, but as an associate of Hand Surgery Associates of Indiana, Inc., our umbrella corporation.

The fellowship experience at the Indiana Hand to Shoulder Center is contemporary. Not only is every fellow didactically instructed on the fine nuances of practical, clinical hand and upper extremity surgery and rehabilitation, but each is also taught the spectrum of practice issues with which they must manage after completing fellowship and joining an institutional or private hand surgery practice. Extensive didactic lectures and lab training experiences, matched by the wide spectrum of clinical exposures our fellows receive while helping to manage the complexities of our busy hand practice, make our graduating hand fellows some of the best-prepared hand surgeons in the United States. Our fellows are routinely exposed to elective hand to shoulder, reconstructive, arthroscopic, minimally invasive, microsurgical, pediatric hand, and traumatic cases. The volume and breadth of cases performed at our center provides our fellows with an unrivaled opportunity to maximize their surgical repertoire.  

Our established fellowship is uniquely positioned to provide you with the extensive training necessary to become a skilled upper extremity orthoplastic surgeon. We look forward to the opportunity to host you for your post graduate fellowship year and welcome you to the IHTSC family.


The Physicians of Indiana Hand to Shoulder Center

Take a look inside the world renowned Indiana Hand to Shoulder center fellowship program.

Take a look at what Dr. Cody Hillin (class of 2020) had to say about his fellowship year at IHTSC.


The Indiana Hand to Shoulder Center’s team of board-certified orthopedic surgeons and fellows are committed leaders in conducting and participating in clinical research programs related to all aspects of the entire upper extremity. Through these research efforts we have been able to improve overall patient care as well as our clinical outcomes. Our surgeons and fellows continually participate in the development and invention of new prosthetic devices, cutting-edge surgical techniques and state-of-the-art treatment solutions.

The Indiana Hand to Shoulder Center frequently partners with industry to conduct both small- and large-scale basic science and clinical research projects. This not only exposes the fellows to the most cutting-edge technological innovations, but also allows the fellows to assimilate the mechanisms through which to develop collaborative relationships with industry.


Some of our research efforts include:

  • Development of elbow replacement

  • Assisting with development of new internal fixation devices for fracture care

  • Investigation of better options for treatment of wrist arthritis

  • Investigation of treatments for nerve compression syndromes

  • Evaluation of novel nerve repair techniques

  • Participation in studies looking at new treatments for Dupuytren’s contracture

  • Assisting in developing devices used for treatment of radius fractures

  • Development of safer and more innovative uses of wrist arthroscopy

  • Evaluation of treatments for basilar thumb arthritis

  • Evaluation of treatments for tendon ruptures and repairs


The fellows also collaborate individually with one of our surgeons to conduct an upper extremity surgery research project. Many of these projects have been published in peer-reviewed literature. Our fellows present their research findings at the annual Tri-State Conference along with other hand surgery fellows from Louisville and Cincinnati programs. 


Dedication to teaching and providing higher education to other physicians and healthcare professionals is the epicenter of the Indiana Hand to Shoulder Center’s vision. Our multi-disciplinary postgraduate fellowship education program for hand, upper extremity, and microvascular surgery is currently one of largest and storied of its kind in the world.

The didactic program at The Indiana Hand to Shoulder Center is robust. Over 50 lectures on topics spanning the corpus of hand and upper extremity surgery, coding, practice management, and therapy are given by our 11 teaching faculty, expert guest lecturers, and therapists. These sessions are augmented by weekly “Logic” sessions where topics receive a deep dive, fuzzy thinking is cleared, and knowledge gaps are found and filled. Multiple labs provide hands-on skill training, from an “ER Boot Camp” at the beginning of the fellowship, to sessions on nerve repair and transfer, flaps, tendon transfers, and both arthroscopy and arthroplasty of the shoulder, elbow, wrist and hand. Our fellows also participate in monthly Journal Club, Quality Improvement conference, and Difficult Problems Conference.

Our Difficult Problems Conference is a unique opportunity to collectively collaborate on the clinical care of patients with challenging upper extremity conditions either due to their severity or limited treatment options. It is an excellent way for the fellows to expand their diagnostic acuity and surgical ingenuity for complicated hand and upper extremity pathologies. In this conference, a patient of one of our partners is invited to the hand center to be evaluated by a committee of entire faculty and fellows who collaborate to develop the optimal treatment plan.

For more than 20 years we have been conducting “Hand Care: Clinical Approaches to Rehabilitation for the Upper Extremity,” a bi-annual meeting geared toward occupational therapists, physical therapists, physicians and nurses with a special interest in hand rehabilitation. This national meeting is recognized as one of the leading hand therapy conferences in the country.

Our surgeons also regularly conduct continuing education workshops, seminars and cadaver labs for physicians, athletic trainers, EMTs, paramedics and workers’ compensation professionals.

The Indiana Hand to Shoulder Center established the Ruth A. Lilly Library to support research and education relating to surgery and therapy of the hand, wrist, elbow and shoulder. The library supports the clinical and research activities of the IHTSC physicians, fellows, orthopedic residents, therapists, nurses, as well as Indiana University School of Medicine students. It houses over 1,200 books pertaining to the upper extremity, microsurgery, plastic surgery, sports medicine and general orthopedics, as well as an online catalog that can be accessed from office or home. Online access to an array of specialized journals and books is available as well.


Since its inception in 1971, the Indiana Hand to Shoulder Center has been committed to an academic tradition of providing the highest quality postgraduate fellowship education to surgeons from around the entire United States who have completed formal orthopedic, plastic or general surgical training. These surgeons have elected to delay their own practice for an additional year in order to expose themselves to intense training in the field of hand and upper extremity surgery.


Of the many applicants who apply each year for our 12-month fellowship positions, we select 6 to train. We have educated over 250 postgraduate surgeons, each of whom is board-eligible when they begin the year with us. These young men and women have gone on after the completion of their fellowship with us to disperse themselves nationwide throughout the full spectrum of academic and private practice, including 3 graduates who have (or will shortly) become President of the American Society for Surgery of the Hand. 


During the program each fellow completes six two month rotations with the Indiana Hand to Shoulder Center orthopedic surgeons following a one on one mentorship training model. They practice in the Indiana Hand to Shoulder Center’s 40,000 square-foot facility that includes:

  • Three operating room suites

  • Two procedure rooms

  • Nerve block room

  • 18 exam rooms

  • X-ray and ultrasound

  • Occupational therapy department

  • Anatomy lab

  • Microvascular skills lab


Each rotation has a mentor-mentee model, with fellows working 1:1 with faculty. Fellows are given progressive responsibility and graduated autonomy and receive privileges in their core specialty at our partner hospital. Fellows take home call for our Level 1 Trauma hospital with a 1 in 6-night frequency. Average case volumes for our fellows is over 1000 cases / year with broad exposure to all facets of hand, upper extremity, microvascular and microneural surgery. 

Fellows are given a $3,000 educational allowance for the purchase of loupes, textbooks, laptops, etc. Additionally, fellows are provided a 1-week microvascular training course at the Mayo clinic. Fellows are encouraged to apply for a mission trip, and time spent is not counted against each fellow’s 3-week vacation allotment. Each fellow also receives 1 week time off to attend a conference of their choice.  


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Francis Aversano, MD (Washington University Orthopaedic Residency)

Priscilla Cavanaugh, MD (Jefferson University Hospital Orthopaedic Residency)

Zachary Finley, MD (Tulane University School of Medicine Orthopaedic Residency)

Aaron Gray, MD (University of Nevada Las Vegas Orthopaedic Residency)

Alexander Hahn, MD (University of Maryland Medical Center Orthopaedic Residency)

Kent Rinehart, MD (University of Nebraska Medical Center Orthopaedic Residency)