{"title":"Hand surgery training in the United Kingdom: why it is not a separate speciality","authors":"C. Ng, G. Bourke, J. Hobby","doi":"10.1177/17531934221095454","DOIUrl":"https://doi.org/10.1177/17531934221095454","url":null,"abstract":"Over the past decades, hand surgery in the United Kingdom (UK) has evolved and matured into a recognized surgical subspeciality. However, the training pathway to be a hand surgeon still begins under the training pathway of a parent speciality, either orthopaedics or plastic surgery. While there have been several past discussions about developing hand surgery as a separate speciality with its own accreditation, such interest has not met with widespread, sustained enthusiasm. This reflects a complex interplay of historical, professional and societal factors, which we seek to explore in this article. In addition, we will outline why we espouse the current structure, but will make suggestions that can be incorporated within the system to help nurture future generation of hand surgeons.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47642408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Celebrating the pioneers in hand surgery","authors":"S. Sabapathy","doi":"10.1177/17531934221097254","DOIUrl":"https://doi.org/10.1177/17531934221097254","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42776428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hand surgery training in Finland","authors":"J. Jokihaara, T. Raatikainen, J. Ryhänen","doi":"10.1177/17531934221095037","DOIUrl":"https://doi.org/10.1177/17531934221095037","url":null,"abstract":"Interest in hand surgery in Finland began in the 1950s, when a few orthopaedic surgeons, dissatisfied with the current results of hand injury treatment, began to familiarize themselves with modern treatments by visiting pioneers of hand surgery in Europe and the United States (US). Hand surgery training in Finland then started in the early 1970s with the establishment of the Finnish Society for Surgery of the Hand (FSSH). All five founding members were specialists in orthopaedics and traumatology, including later International Federation of Societies for Surgery of the Hand (IFSSH) Pioneers of Hand Surgery, Kauko Solonen, Henry Brummer, Martti Vastamäki and Simo Vilkki. The training was practical, unstructured and did not lead to any official qualification. However, the FSSH strongly advocated establishing an official hand surgery specialization, like in Sweden and the US. The National Board of Medicine was supportive, but the proposal met strong resistance from other specializations, as it was seen ‘an unnecessary addition’ to the field of surgery.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42373581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Das De, A. Chin, A. Chong, Mark Edward Puhaindran, S. Sechachalam, L. Teoh
{"title":"Evolution of hand surgery as an independent speciality over three decades: the Singapore model","authors":"S. Das De, A. Chin, A. Chong, Mark Edward Puhaindran, S. Sechachalam, L. Teoh","doi":"10.1177/17531934221095472","DOIUrl":"https://doi.org/10.1177/17531934221095472","url":null,"abstract":"In Singapore, hand surgery has been an independent speciality with its own training programme for more than 30 years. Just as in many countries, the drive for specialization was borne out of an overwhelming clinical need (Pei-Yein et al., 2021; Pho and Pereira, 1992; Teoh, 1995). The 1960s and 1970s were a period of rapid industrialization and growth, inevitably leading to an increase in devastating upper extremity injuries. The Ministry of Health recognized that these injuries demanded special expertise and initiated a phased approach to develop hand surgery as an independent speciality. Hand surgery departments were formed in two tertiary hospitals – Singapore General Hospital (SGH) in 1985 and National University Hospital (NUH) in 1990. A dedicated training programme was started in 1990 and hand surgery was recognized as an independent speciality in 1997. This article reviews the evolution of the hand surgery speciality in Singapore over the past three decades.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43236429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Statistics in publishing: the (mis)use of the p-value (part 1)","authors":"Dieuwke C. Broekstra, M. D. de Boer, Jonah Stunt","doi":"10.1177/17531934221095377","DOIUrl":"https://doi.org/10.1177/17531934221095377","url":null,"abstract":"In hand surgery research, most studies, whether observational studies or randomized controlled trials (RCT), are aimed at finding out whether there is an effect (association or difference) of a certain determinant on a specific outcome. This is usually determined using null-hypothesis significance testing (NHST), in which a p-value <0.05 is considered as evidence that the findings are significant. Although this method is widely used, it has been criticized since its inception. The critique has been mainly focused on the misuse of NHST, but also more conceptually on the method itself. In part 1 of this two-part article, we discuss some examples of how the p-value can be misused, using a simulated dataset partly based on real data from an RCT (Broekstra et al., 2022). In part 2, we will discuss the conceptual criticism and offer some guidance on alternatives. In this example study, women with a distal radial fracture were randomized either to an intervention (cast þ rehabilitation programme) or control (cast only) group in a 1:1 ratio. The intervention was aimed at restoring hand function, which was measured using the Patient-Rated Wrist Evaluation (PRWE), a validated patient-reported outcome measure for determining hand function in patients with wrist problems, with a score ranging between 0 (no problems) and 100 (severe problems).","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41425790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Solidarity, support and supply","authors":"J. Hobby, D. Herren","doi":"10.1177/17531934221097015","DOIUrl":"https://doi.org/10.1177/17531934221097015","url":null,"abstract":"On 24 February 2022, the world witnessed the invasion of Ukraine by Russia, triggering one of the largest exoduses of refugees (estimated to be 4.5 million), and a human catastrophe in terms of blast and ballistic injuries, among soldiers and civilians alike. The impact of this conflict has affected every one of us, especially in Europe. On the day of invasion, we said goodbye to our Ukrainian hand colleagues at the Federation of Societies of Surgery of the Hand (FESSH) Academy as they returned home to their families, and shortly after, FESSH issued a statement to show support for all victims in the tragedy centred around the three ‘S’s: Solidarity, Support and Supply. Our colleagues in Ukraine are currently treating huge numbers of gunshot and blast injuries, often in difficult circumstances, and in some cases at considerable personal risk. Many became experienced in the management of these injuries due to ongoing conflict in various regions, but some have less experience and are struggling with unfamiliar injuries. To provide support, FESSH and the British Society of Surgery for the Hand (BSSH) have set up a weekly webinar programme with lectures on the fundamentals of managing combat injuries, drawing on the experience of our colleagues in the military, and case discussions presented by our Ukrainian colleagues (Figure 1). In addition, the Journal has invited a two-part article addressing the contemporary management of combat injuries, including lessons learned from the United Kingdom (UK) National Centre in Birmingham. These will be made available online and translated into the Ukrainian language. The Editorial team have selected a series of relevant articles from the Journal and our publisher, SAGE, has kindly made these available for open access. It is hoped that these efforts by FESSH, BSSH and the Journal will play a part, no matter how small, in supporting our international colleagues. Sadly, it seems increasingly unlikely that our colleagues will be able to join us for the International","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44648342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unity in hand surgery","authors":"W. Lam","doi":"10.1177/17531934221097014","DOIUrl":"https://doi.org/10.1177/17531934221097014","url":null,"abstract":"","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44202267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hand surgery training in Sweden – bridging the gap between specialities","authors":"P. Axelsson, S. Farnebo, A. Björkman","doi":"10.1177/17531934221095776","DOIUrl":"https://doi.org/10.1177/17531934221095776","url":null,"abstract":"Sweden has a government-funded healthcare system, providing its 10 million residents with medical care. There are hand surgery departments in all of the seven university hospitals, providing 24-hour emergency hand surgery care and specialized treatments. These departments treat all major hand trauma cases, such as fractures, tendon injuries, nerve injuries and replantations, and serve as referral centres for elective hand surgery cases, including congenital malformations, spasticity, plexus injuries and complex wrist reconstructions. Minor hand trauma, and common elective procedures, are handled by these hand surgery departments but also in orthopaedic departments. The regulation of which speciality should treat which acute and elective hand surgery disorders is handled by a national agreement between the Swedish Society for Surgery of the Hand (SHF) and the Orthopaedic Society. Hand surgery conditions are currently not being treated at any of the plastic surgery departments.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41958595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hand surgery training in the United States of America","authors":"K. Chung","doi":"10.1177/17531934221095677","DOIUrl":"https://doi.org/10.1177/17531934221095677","url":null,"abstract":"Hand surgery was first recognized as a distinct speciality when Dr Sterling Bunnell was commissioned by the United States of America (USA) Armed Forces to teach hand surgery across military units. Under his tutelage, a number of his students became Founders of the Hand Surgery speciality in America. In January 1946, Dr Bunnell and a group of other surgeons returning from World War II met in Chicago to fulfil their vision of establishing hand surgery as a unique speciality; here, the American Society for Surgery of the Hand (ASSH) was born. These founders came from three separate surgical specialities: general surgery, plastic surgery and orthopaedic surgery. Today, hand surgery training is embedded within these specialities in the USA as a fellowship pathway after receiving fundamental exposure in one of these core disciplines. In the ensuing years, a number of novel techniques were developed, such as rigid fixation of fractures, joint replacement surgery, microsurgery in promoting replantation and flap surgery, wrist surgery and arthroscopy. These advancements come with the challenge of training a comprehensive hand surgeon who is capable of complex trauma care, able to perform complicated microsurgery procedures for mangled hand injuries, as well as advanced bone fixation procedures. Additionally, the growth of nerve surgery requires the hand surgeon to understand peripheral nerve anatomy and physiology to tackle intriguing problems extending from the brachial plexus to the digital nerves.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47307967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stefanie Frances Gibb Née Andrew, C. Clark, Z. Sheppard, T. Crook
{"title":"Exploration of rehabilitation through the use of virtual reality interventions for patients with hand conditions: a scoping review","authors":"Stefanie Frances Gibb Née Andrew, C. Clark, Z. Sheppard, T. Crook","doi":"10.1177/17531934221098504","DOIUrl":"https://doi.org/10.1177/17531934221098504","url":null,"abstract":"The use of virtual reality to aid the rehabilitation of hand and upper-limb conditions has been an emerging field over the past decade. The majority of research in this field has been focused on neurological conditions for example post-stroke, with major advances being made to improve hand function through various robotic and digital techniques. In spite of the technological advancements in virtual reality rehabilitation, it is not readily used in current practice for hand or upper-limb conditions. The recent crisis of COVID-19, and the requirements and/or preferences of some people to receive rehabilitation at home have highlighted the importance of developing this technology so that it could become part of standard practice. This scoping review was conducted to explore research addressing immersive virtual reality in hand rehabilitation. The objectives were to identify the strengths and weaknesses of current technology and highlight any gaps in knowledge which could inform future research.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45911074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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