Hand Surgery in Different Countries: Hand Surgery in Thailand

Modern hand surgery in Thailand started after the end of World War II. It is divided into 4 phases. In the initial phase (1950-1965), the surgery of the hand was mainly performed by general surgeons. In 1965-1975, which was the second phase, many plastic surgeons and orthopaedic surgeons graduated from foreign countries and came back to Thailand. They played a vital role in the treatment of the surgery of the hand and set up hand units in many centers. They also contributed to the establishment of the “Thai Society for Surgery of the Hand,” which still continues to operate. In the third phase (1975-2000), there was a dramatic development of microsurgery because of the rapid economic expansion. There were many replantation, free tissue transfers, and brachial plexus surgeries in traffic and factory-related accidents. The first hand-fellow training program began in 1993. In the fourth phase (since 2000), the number of hand injuries from factory-related accidents began declining. But the injury from traffic accidents had been increasing both in severity and number. Moreover, the diseases of hand that relate to aging and degeneration had been on the rise. Thai hand surgeons have been using several state-of-the-art technologies such as arthroscopic and endoscopic surgery. They are continuing to invent innovations, generating international publications, and frequently being invited as speakers in foreign countries.     

Hand Surgery in Different Countries: Hand Surgery in New Zealand

Hand surgery in New Zealand has steadily grown from its origins in plastic surgery and orthopaedic surgery into its own discipline. There has been much progress and innovation in hand surgery that has originated from New Zealand and this review acknowledges the historical figures and events that have led to our present position. The current and future directions of hand surgery in our country are also discussed. As a small and remote country, we are very fortunate to have close relationships with other international hand societies. Through these relationships and the efforts of committed regional hand surgeons, the art and science of hand surgery in New Zealand continues to progress.     

《中华手外科杂志》1995年至1999年的引文分析

目的 对最近５卷《中华手外科杂志》论文的引文进行分析,以提供最有应用价值的手外科文献资料。方法 对１９９５年至１９９９年２１期《中华手外科杂志》中主要栏目的７３２篇论文的引文进行统计学分析。采用专家和读者问卷调查法,推荐熟悉和有价值的文献。结果 ２１期杂志中刊登引文的论文共４６７篇,引文量２４０８条。引文语种以英文、中文为主。引文类型以期刊文章为主,自引率呈逐年递增的趋势。引文核心文献为《中华手外     

The 9th Congress of the Chinese Hand Surgery Society

Hand surgery started in China when Dr. Shuhuan Wang, founder of hand surgery in China, established China's first hand surgery service in Jishuitan Hospital in Beijing, September 1958. Shortly after this, in southern China, a division of hand surgery was established at Huashan Hospital, Shanghai, in 1960. Owing to the dedication of generations of hand surgeons, hand surgery has developed and flourished throughout China. Nowadays, more than 60 medical centers and hospitals have hand surgery service, and over 10 of them have an independent hand surgery department. © 2005 Wiley‐Liss, Inc. Microsurgery 25:90–95, 2005.     

Hand Surgery in Different Countries: Hand Surgery in Cambodia

As a lower middle-income nation, Cambodia has made significant improvements in basic health but hand surgery development continues to lag behind due to scarcity of trained and quality surgical manpower. Most of the hand surgery development locally has been due to surgical volunteers from Asia, Europe, and the United States. The introduction of a structured and systematic community-oriented hand surgery training over a 5-year period was successful in producing local surgeons to meet the basic needs of hand surgery patients. Brachial plexus surgery has benefited significantly, with local surgeons able to independently manage cases with minimal support. With the expansion of local surgical manpower and guidance, motivation, and assistance of regional hand surgeons, the future of hand surgery in Cambodia looks promising.     

Hand Surgery in Different Countries: Hand Surgery in Japan

Japan has faced the most challenging times in the past. Through precise diligence by stalwarts and doyens of initial hand surgeons, it led an incredible path for the most significant moments of hand surgery. This article describes the early phase of development of Japanese Society for Surgery of the hand, substantial and innovative contributions from surgeons. A noteworthy and significant achievement in the hand surgery is microsurgery and its utilities for all hand-related diseases. The first replantation of the thumb, toe transfers and wrap-around flaps are the effective surgical techniques developed and imparted to the fellow hand surgeons worldwide. We had a particular interest in congenital hand surgery and developed a modification of congenital hand classifications and introduced many surgical techniques. Besides, we grew ourselves refining more in hand and microsurgery, innovating flexor tendon repair, peripheral nerve surgeries, wrist arthroscopy, joint replacements, external fixators, and implant arthroplasty for rheumatoid hand. We share our health care information, insurance working model and hand surgery training schedule in Japan.     

Hand and forearm injuries from penetrating projectiles

Compared with other surgical literature published after the Vietnam and Persian Gulf wars, hand surgery literature has been relatively void of information regarding projectile injury. Wound ballistics research of the past 10 years has shown that objective evaluation of tissue disruption is the only valid guide to treatment. The hand's anatomy requires hand surgeons to be more careful in tissue excision. Hand surgeons, therefore, do not have the luxury of "cutting till it bleeds." The purpose of this article is to support the methods that hand surgeons have traditionally used and to caution the inexperienced surgeon who may be inclined to excise uninjured tissue.     

The Chicago School of Hand Surgery

The Chicago School of Hand Surgery played a pivotal role in the genesis of the specialty of hand surgery in the United States and abroad. Drs. Alan Kanavel, Sumner Koch, Michael Mason, and Harvey Allen were among the first "modern" surgeons to carefully and systematically assess the care and treatment of hand injuries and hand pathology. This article highlights the lives and contributions of the founders of the Chicago School of Hand Surgery.     

Hand surgery training

Training of the hand surgeon HAND SURGEON A CONCEPT: The hand surgeon is supposed to be in charge of all the hand lesions regarding, skeleton, muscles, tendons, nerves and vessels. He has to be able to insure reparation and coverage of all of them. So he is involved in all the structures, which insure integrity and function of the hand. PURPOSE AND WAYS OF TRAINING: To obtain the asked ability, the hand surgeon training has to be global and sustained by two underlying surgical specialities: orthopedic surgery and plastic and reconstructive surgery. From 2000 after many years of dealings, a Right to the Title in Hand Surgery was born. This Right to the Title wants to be the formal recognition of the specific training of the hand surgeon. For the well-recognized ancient hand surgeons they need to be confirmed by one's peers. Now a day the hand surgeon has to satisfy to this specific training: Passed the complete training and exam of the Orthopedic or Plastic surgery board. Spent at least 6 months as resident in the other underlying specialty. Passed a microsurgery examination. Passed one of the four national Hand Surgery diplomas (DIU/Inter-Universitary Diploma). The examinations have been harmonized. A common formation is delivered regarding hand surgery, the way of examination is the same and the formation is 2 years long. The final exam is presented in front of board of examiners where a teacher of one of the other three national diplomas is present. Spent at least 2 years in a formative hand surgery unit, listed by the French College of Hand Surgeons, as senior surgeon. Those requirements are heavy to assume and need a heavy personal involvement. That seems to be necessary to have an ability level as high as possible. Emergency surgery practice is absolutely necessary in this training. All the 17 university formative hand surgery units listed by the French College of Hand Surgeons are members of the FESUM (European Federation of the Emergency Hand Units). Unfortunately it is non-sufficient to train the necessary number of hand surgeons needed in France today. So we try to obtain from the authority the formal recognition of a training period in private practice. Eleven out of the 28 hand units listed as formative by the French College of Hand Surgeons are in private practice and may be recognized as formative in the hand surgeon training. That needs to create an official agreement between university and private Units. This part of the training is yet accepted by the Right to the Title commission for a 6-month training period. But this needs a legal modification or adaptation of the private units legal status so they will be able to offer a quite equivalent conditions of training. Now a days 233 surgeons in France passed the Right to the Title. Among them, the oldest do not have emergency practice any more. So unfortunately, out of 1,400,000 hand injuries a year in France, only few are actually cared by hand surgeons. The emergency training needs at least a three to four senior surgeons team, operating and caring emergencies, 24 h a day, 365 days a year. They need to be surrounded by high-level technical facilities for this type of surgery. Only this type of unit may have a frequent severe hand traumatology practice, especially regarding microsurgery. But on the other hand a less complex hand unit operating only planed surgery and less complicated emergencies, may also be definitively formative. This only depends on the hand surgeon's qualification. It is only with a very demanding and high-level training program that our credibility as hand surgeon may be definitively established. The mainstay of this training is the combined action of the FESUM, the French College of Hand Surgeons and the DIU diploma. The Right to the Title formally confirms that training. For university or private unit, to be a member of the FESUM, must continue to guarantee a high level training regarding emergencies as in number as in complexity. We proposed as minimum level of practice (a year) to be a formative hand surgery unit: 10-15 hand and upper limb replantations; 25-30 very severe hand injuries (revascularization etc.); at least 1000-1500 hand surgery procedures.     

The Efficiency of WhatsApp in Teleconsultation of Finger Vascularity in Hand Surgery

Background Teleconsultation over the smartphone is now widely used in modern medicine in the management of burns, flap cover, upper extremity trauma, and in the assessment of the feasibility of reimplantation in amputated fingers. The development of the WhatsApp application has enhanced the smartphone''s efficiency remarkably to transmit images in clinical and academic settings with its failsafe and encrypted technology. In hand surgery, a teleconsultation technology must communicate details of finger vascularity effectively. However, there is a paucity of evidence on the functionality of these modern teleconsultation technologies in Hand Surgery. Here, the authors have estimated the efficiency of the WhatsApp teleconsultation in the assessment of finger vascularity. Materials and Methods In two phases, the authors transmitted clinical photographs of vascular and avascular fingers to experienced hand surgeons over the WhatsApp and asked them to assess the finger vascularity. The efficiency of the WhatsApp teleconsultation in assessing the details of finger vascularity was estimated from their responses. Results Despite 81.06% of the hand surgeons rating the vascular fingers on the transmitted photographs correctly, only 44.95% detected the avascular digits accurately; that is, 55.05% of the surgeons failed to diagnose the avascularity of fingers. This suggests serious implications in a clinical setting. The intra- and the inter-rater reliability values were 0.232 and 0.6086 (with 95% confidence interval), respectively, which indicated poor reliability of the WhatsApp teleconsultation regarding the assessment of finger vascularity. Conclusion The authors, therefore, conclude that WhatsApp is inadequate in teleconsultation given the value of vascularity details of the fingers in making a diagnosis in hand surgery.     

The history and evolution of hand transplantation

Hand transplantation has proven itself to be a viable treatment option for upper extremity reconstruction. It has grown through advancements in several critical areas: microsurgery, transplant immunology, and hand surgery. The field has also benefited from a global effort with active transplant centers in 3 different continents. The early struggles and breakthroughs of hand transplantation's past have shaped and formed its current state. This article traces the events of the modern era of hand transplantation.     

《中华手外科杂志》2005-2009年引文分析

目的 研究<中华手外科杂志>参考文献的引用规律,了解我国手外科领域论文引文的一般规律和科研人员吸收利用科技文献的情况.方法 采用文献计量学方法 ,对该刊2005至2009年共30期942篇文章的引文进行逐篇统计,记录分析,计算引文量、引文率、引文语种、引文类型、引文年代和普赖斯指数.结果 该刊共刊载文献942篇,引文率为87.37%引文量5 390条,平均为6.55条.主要引文类型为期刊(90.71%)和图书(9.29%),普赖斯指数44.9r7%,自引率31.61%,被引用频次前18位的中外文期刊的文献引用量占期刊引文总量的66.21%.结论 <中华手外科杂志>是手外科领域高质量的专业核心期刊,引文的外文语种较为单一,引文内容较新颖.     

《中华手外科杂志》2005-2009年引文分析

目的 研究<中华手外科杂志>参考文献的引用规律,了解我国手外科领域论文引文的一般规律和科研人员吸收利用科技文献的情况.方法 采用文献计量学方法 ,对该刊2005至2009年共30期942篇文章的引文进行逐篇统计,记录分析,计算引文量、引文率、引文语种、引文类型、引文年代和普赖斯指数.结果 该刊共刊载文献942篇,引文率为87.37%引文量5 390条,平均为6.55条.主要引文类型为期刊(90.71%)和图书(9.29%),普赖斯指数44.9r7%,自引率31.61%,被引用频次前18位的中外文期刊的文献引用量占期刊引文总量的66.21%.结论 <中华手外科杂志>是手外科领域高质量的专业核心期刊,引文的外文语种较为单一,引文内容较新颖.     

《中华手外科杂志》2005-2009年引文分析

目的 研究<中华手外科杂志>参考文献的引用规律,了解我国手外科领域论文引文的一般规律和科研人员吸收利用科技文献的情况.方法 采用文献计量学方法 ,对该刊2005至2009年共30期942篇文章的引文进行逐篇统计,记录分析,计算引文量、引文率、引文语种、引文类型、引文年代和普赖斯指数.结果 该刊共刊载文献942篇,引文率为87.37%引文量5 390条,平均为6.55条.主要引文类型为期刊(90.71%)和图书(9.29%),普赖斯指数44.9r7%,自引率31.61%,被引用频次前18位的中外文期刊的文献引用量占期刊引文总量的66.21%.结论 <中华手外科杂志>是手外科领域高质量的专业核心期刊,引文的外文语种较为单一,引文内容较新颖.     

Surgery of the hand in Poland--a controversial issue]

Since hand surgery separated from orthopedic and general surgery as an independent subspeciality, the problem of training new surgery came into life. Many studies indicate that a country with Poland's population should have about 250-300 trained hand surgeons. Current estimates show that there are three to four times less hand surgeons than necessary. The establishment of the Section of Hand Surgery by the Polish Orthopedic Society in 1965 and the founding of the Polish Society for Surgery of the Hand (1998) made formal ground for taking up both training in hand surgery and assenting it as a separate clinical sub-category. No official statement has been made in this matter neither by the Ministry of Health or by any scientific society. The authors suggest the need for organizing a system for training and achieving certified qualifications in hand surgery, for example like the FESSH European diploma in hand surgery. It seems that this matter should be discussed broadly among both general and orthopedic surgeons in order to create a separate sub-category for hand surgery.     

《中华手外科杂志》引文变迁分析

目的 了解我国手外科学领域论文引文的一般规律和著者吸收利用科技文献的实际情况。方法 利用文献计量方法和引文分析法,对《中华手外科杂志》5年（1995年－1999年）的论文引文的平均值、引文的类型等进行统计学分析。结果 论文平均引文量为5．4条,中外文的比例为1：1．3,期刊总引文量的87．1％,引文自引率为11．0％。被引文献峰值（9．8％）是在发表后的第4年,文献半衰期为6－7年。结论 期刊是手外科学论文的主要引文源,按照布拉德福的文献主散规律,找出8种核心期刊而《中华手外科杂志》在其中占首位。     

Teaching Pediatric Hand Surgery in Vietnam

BACKGROUND: International volunteering missions are becoming an important focus of plastic surgeons in the United States. The purpose of this paper is to describe the teaching of pediatric hand surgery in Vietnam to share the lessons learned from this project. METHODS: Two medical education trips were conducted to the no. 1 Children's Hospital in Ho Chi Minh city (Saigon) to teach pediatric hand and burn reconstructive surgery to the surgeons and therapists. This is the main referral children's hospital for the country, and pediatric hand surgery expertise is not available. RESULTS: Structured education programs were conducted over two trips to introduce congenital hand surgery and burn reconstructive procedures using flap techniques. The education programs included lectures and surgical demonstrations of selected procedures. Their proficiency was verified by supervised conduct of these operations. CONCLUSIONS: A well-conceived medical education program can introduce complex surgical discipline to a country. Through two trips, the surgeons at this referral center will have the capability to take care of many children requiring reconstructive hand surgery.     

Patient Expectations and Satisfaction With Foot and Ankle Surgery in Saudi Arabia: A Retrospective Cohort Study

The success of surgery is associated not only with the quality of the procedure but also with the degree to which it meets the patient’s expectations. Limited data are available on patient expectations related to foot and ankle surgery in Saudi Arabia. Our study assessed the preoperative expectations and postoperative satisfaction of patients who had undergone foot and ankle surgery at 1 hospital in Saudi Arabia. A survey-based, retrospective cohort study was conducted among patients who had undergone elective foot or ankle surgery at King Abdul-Aziz Medical City, Riyadh, from January 2010 to December 2015. The participants, who were randomly selected, were interviewed by telephone in April 2016. The average interval between the surgery and the telephone interview was 1 year. We performed stepwise multiple logistic regression analysis to assess the predictors of patient satisfaction with surgery. A total of 383 participants were interviewed (51.7% male). The sample included participants with a wide age range. Most participants had undergone surgery because of pain (74.9%) or movement difficulties (37.1%); only 9.4% had undergone surgery for cosmetic reasons. Most (80%) of the participants reported they were satisfied with the surgical results. Young age, bilateral surgery, efficient pain control, and fulfilled expectations had the greatest positive effects on satisfaction. The findings of the present study will help improve our understanding of the expectations of patients who undergo elective foot and ankle surgery in Saudi Arabia. Additionally, our results can give orthopedic surgeons insight into patients' ideas and concerns regarding their surgery, which might ultimately improve communication between surgeons and patients.     

Hand Surgery in Different Countries: Hand Surgery in Malaysia

We have all heard the old aphorism, “Necessity is the mother of invention.” While the provenance of the proverb is uncertain, its truth is not in doubt. This is true for the development of hand surgery in Malaysia. As part of the management for leprosy, patients with high ulnar nerve palsies were managed by the pioneers of hand surgery in Malaysia. They did tendon transfers to improve the quality of life of these patients. Since then, hand surgery in Malaysia have grown leaps and bounds. From a small humble beginning in the suburb of Sungai Buloh to organizing the 10th Congress of Asian Pacific Federation of Societies for Surgery of the Hand, hand surgery in Malaysia will only get better with time.     

Birth and development of the FESUM (European Federation of Hand Emergency Services)

The European Federation of Hand Emergency Services (FESUM) was founded in France in 1979 and established all over the country and extended to other European countries in 1989. The aim of this federation is to assure the best possible treatment for hand injuries, thanks to the coordination of the orthopaedic or plastic surgery department which satisfy the standards established and controlled by the federation as well as the development and research in the field of hand trauma and applications of microsurgery. In collaboration with the French Society of Hand Surgery and the French College of Hand Surgery, it fulfills a triple mission of treatment, teaching and research in the specific field of this surgery. The author evokes the present role of the FESUM and the future problems to be solved in order to develop this specialized surgery which plays a major social and economic role.