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Evolution and Current Status of Hand Surgery Practice in Asia and Europe
Hand Surgery in Asia and Europe
P re f a c e E v o l u t i o n an d C u r re n t S t a t u s o f H a n d S u r g e r y Pr a c t i c e i n A s i a a n d Eu ro p e
Jin Bo Tang, MD
Grey Giddins, FRCS (Orth), EDHS
Many hand problems were recognized first by European surgeons, and their management developed in Europe. Recently, the number of hand surgeons in Asia has increased substantially as has their worldwide influence. In an age of instant communication, multinational international meetings, and international journals, it would be easy to assume that the management of a common hand problem will be the same in countries of equivalent wealth. In fact, that is to ignore the myriad of different influences that affect how we practice. For example, for distally amputated finger, cosmetic concerns in East Asia encourage more replants; the financial pressures and volume of work in the National Health Service in the United Kingdom encourage a nonoperative approach. Different methods of funding in different countries will also bias their practice. It is interesting and enlightening to know and understand how others treat those we treat. Over more than three decades, the previous 32 volumes of Hand Clinics have not designated an entire issue to hand surgery in Europe and Asia, although surgeons from the two regions have frequently authored articles in Hand Clinics. We felt that it would be worthwhile to cover the current status of aspects of hand surgery in two regions in a specific issue of Hand Clinics. This proposal was immediately welcomed by the editors at Elsevier and the consulting editor, Dr Kevin Chung.
Hand Clin 33 (2017) xiii–xiv http://dx.doi.org/10.1016/j.hcl.2017.05.001 0749-0712/17/Ó 2017 Published by Elsevier Inc.
Our invitations to the leading hand surgeons over the two regions were warmly received, and high-quality reviews from well-recognized and reputed centers have provided a thorough review and update on their practices. While the reviews are mainly relevant to their own practice or the current practice in their respective regions, they provide unique and novel insights. Readers will note how wide-awake surgery has become increasingly popular, how strong tendon repairs have safely improved the outcomes of tendon repair, how the function of carpal ligaments is appreciated from a different viewpoint, how conservative treatment should be an important, frequent, and efficient tool for hand fractures, how European colleagues treat difficult finger joint problems, and how Asian surgeons use vascularized flap transfers for immediate soft tissue reconstruction. Interesting and thought-provoking reviews can also be found on the topics of congenital hand disorders, peripheral nerve repair, scaphoid fractures, and wrist replacement. In the final article of the issue, six senior hand surgeons from six countries were invited to offer their views, experience, and comments on a few common clinical problems. Reading this review is to experience a traveling fellowship; like conventional traveling fellowship, these views provide eye-opening experiences to challenge and enhance our knowledge. Through this article, the
hand.theclinics.com
Editors
xiv
Preface readers are led on a tour in these hand centers with senior hand surgeons explaining how some common hand problems are treated in their centers. Though there is common ground in their different approaches, there are also striking differences in the management between different centers and different countries. Besides inspiration from the different approaches, the contents should stimulate us to further explore that which we do not know, or do not know for sure. In Asia and Europe there is a federation of societies for hand surgery in each of the two regions. The annual congress of the Federation for European Societies for Surgery of the Hand (FESSH) is a major event of hand surgery each year. This year’s congress in Budapest was attended by 1780 participants from 68 countries. Most of the authors for this issue are active in two federations. We are very grateful to authors of the articles in this issue for their time and contribution. While aiming to provide an update on current major topics in hand surgery, we could not cover every
important topic. We hope the contents in this issue foster communication between colleagues across regions. It has been a privilege to edit this issue. We appreciate the editorial team of the publisher, especially Jennifer Flynn-Briggs and Kristen Helm, for their consistent and careful support and guidance during the production process. Jin Bo Tang, MD Department of Hand Surgery Affiliated Hospital of Nantong University 20 West Temple Road Nantong, Jiangsu, China Grey Giddins, FRCS (Orth), EDHS University of Bath 29a James Street West Bath BA1 2BT, UK E-mail addresses: [email protected] (J.B. Tang) [email protected] (G. Giddins)
P re f a c e E v o l u t i o n an d C u r re n t S t a t u s o f H a n d S u r g e r y Pr a c t i c e i n A s i a a n d Eu ro p e
Jin Bo Tang, MD
Grey Giddins, FRCS (Orth), EDHS
Many hand problems were recognized first by European surgeons, and their management developed in Europe. Recently, the number of hand surgeons in Asia has increased substantially as has their worldwide influence. In an age of instant communication, multinational international meetings, and international journals, it would be easy to assume that the management of a common hand problem will be the same in countries of equivalent wealth. In fact, that is to ignore the myriad of different influences that affect how we practice. For example, for distally amputated finger, cosmetic concerns in East Asia encourage more replants; the financial pressures and volume of work in the National Health Service in the United Kingdom encourage a nonoperative approach. Different methods of funding in different countries will also bias their practice. It is interesting and enlightening to know and understand how others treat those we treat. Over more than three decades, the previous 32 volumes of Hand Clinics have not designated an entire issue to hand surgery in Europe and Asia, although surgeons from the two regions have frequently authored articles in Hand Clinics. We felt that it would be worthwhile to cover the current status of aspects of hand surgery in two regions in a specific issue of Hand Clinics. This proposal was immediately welcomed by the editors at Elsevier and the consulting editor, Dr Kevin Chung.
Hand Clin 33 (2017) xiii–xiv http://dx.doi.org/10.1016/j.hcl.2017.05.001 0749-0712/17/Ó 2017 Published by Elsevier Inc.
Our invitations to the leading hand surgeons over the two regions were warmly received, and high-quality reviews from well-recognized and reputed centers have provided a thorough review and update on their practices. While the reviews are mainly relevant to their own practice or the current practice in their respective regions, they provide unique and novel insights. Readers will note how wide-awake surgery has become increasingly popular, how strong tendon repairs have safely improved the outcomes of tendon repair, how the function of carpal ligaments is appreciated from a different viewpoint, how conservative treatment should be an important, frequent, and efficient tool for hand fractures, how European colleagues treat difficult finger joint problems, and how Asian surgeons use vascularized flap transfers for immediate soft tissue reconstruction. Interesting and thought-provoking reviews can also be found on the topics of congenital hand disorders, peripheral nerve repair, scaphoid fractures, and wrist replacement. In the final article of the issue, six senior hand surgeons from six countries were invited to offer their views, experience, and comments on a few common clinical problems. Reading this review is to experience a traveling fellowship; like conventional traveling fellowship, these views provide eye-opening experiences to challenge and enhance our knowledge. Through this article, the
hand.theclinics.com
Editors
xiv
Preface readers are led on a tour in these hand centers with senior hand surgeons explaining how some common hand problems are treated in their centers. Though there is common ground in their different approaches, there are also striking differences in the management between different centers and different countries. Besides inspiration from the different approaches, the contents should stimulate us to further explore that which we do not know, or do not know for sure. In Asia and Europe there is a federation of societies for hand surgery in each of the two regions. The annual congress of the Federation for European Societies for Surgery of the Hand (FESSH) is a major event of hand surgery each year. This year’s congress in Budapest was attended by 1780 participants from 68 countries. Most of the authors for this issue are active in two federations. We are very grateful to authors of the articles in this issue for their time and contribution. While aiming to provide an update on current major topics in hand surgery, we could not cover every
important topic. We hope the contents in this issue foster communication between colleagues across regions. It has been a privilege to edit this issue. We appreciate the editorial team of the publisher, especially Jennifer Flynn-Briggs and Kristen Helm, for their consistent and careful support and guidance during the production process. Jin Bo Tang, MD Department of Hand Surgery Affiliated Hospital of Nantong University 20 West Temple Road Nantong, Jiangsu, China Grey Giddins, FRCS (Orth), EDHS University of Bath 29a James Street West Bath BA1 2BT, UK E-mail addresses: [email protected] (J.B. Tang) [email protected] (G. Giddins)