Pub Date : 2022-06-14DOI: 10.1177/17531934221105225
D. Roberts, R. Jose, L. Duraku, Matthew j wordsworth, M. Foster, D. Mortiboy, E. Sellon, S. Stapley, D. Power
This is the second of a two-part review article on the management of conflict injuries, focused on the reconstructive strategies for bone, nerve and soft tissue and to provide guidance on assessing and managing common complications associated with complex upper limb injuries. Following assessment and early surgical management, the conflict casualty will require further wound evaluation and planning prior to definitive reconstruction of limb injuries. Surgical management of the upper limb injury should aim, where possible, to preserve the limb and allow functional reconstruction. The principles of the second look procedure are to assess wound progression, further reduce the risk of infection and plan definitive reconstruction with adequate soft tissue cover. The prerequisites for successful surgical reconstruction are a stable patient, combined orthoplastic surgery expertise supported by physiotherapists and hand therapists.
{"title":"Management of conflict injuries to the upper limb. Part 2: reconstruction and managing complications","authors":"D. Roberts, R. Jose, L. Duraku, Matthew j wordsworth, M. Foster, D. Mortiboy, E. Sellon, S. Stapley, D. Power","doi":"10.1177/17531934221105225","DOIUrl":"https://doi.org/10.1177/17531934221105225","url":null,"abstract":"This is the second of a two-part review article on the management of conflict injuries, focused on the reconstructive strategies for bone, nerve and soft tissue and to provide guidance on assessing and managing common complications associated with complex upper limb injuries. Following assessment and early surgical management, the conflict casualty will require further wound evaluation and planning prior to definitive reconstruction of limb injuries. Surgical management of the upper limb injury should aim, where possible, to preserve the limb and allow functional reconstruction. The principles of the second look procedure are to assess wound progression, further reduce the risk of infection and plan definitive reconstruction with adequate soft tissue cover. The prerequisites for successful surgical reconstruction are a stable patient, combined orthoplastic surgery expertise supported by physiotherapists and hand therapists.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43892521","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}
Pub Date : 2022-06-14DOI: 10.1177/17531934221103688
S. Hashimoto, H. Kato, S. Uchiyama, T. Itsubo, S. Matsuda, M. Hayashi
We evaluated the tendon length and excursion after extensor tendon grafting following ruptures at the distal radioulnar joint in eight patients. The mean patient age was 70.8 years (range 58 to 84), and the mean follow-up period was 63 months (range 12 to 129). Radiographic markers were placed on ends of the grafted tendon to assess changes in length and passive excursion. The mean length of the grafted tendon and mean passive excursion were 68.2 mm and 4.4 mm immediately after tendon grafting, 76.1 mm and 7.1 mm at 1 year postoperatively, and 76.3 mm and 7.3 mm at final follow-up, respectively. The mean elongation of the grafted tendon was 12% and mean increase of excursion was 2.9 mm. We recommend that tension set during extensor tendon grafting should be with the metacarpophalangeal joint of the affected finger in a slightly extended position as compared with adjacent fingers. Level of evidence IV
{"title":"Changes in tendon length and excursion following extensor tendon grafting at the distal radioulnar joint","authors":"S. Hashimoto, H. Kato, S. Uchiyama, T. Itsubo, S. Matsuda, M. Hayashi","doi":"10.1177/17531934221103688","DOIUrl":"https://doi.org/10.1177/17531934221103688","url":null,"abstract":"We evaluated the tendon length and excursion after extensor tendon grafting following ruptures at the distal radioulnar joint in eight patients. The mean patient age was 70.8 years (range 58 to 84), and the mean follow-up period was 63 months (range 12 to 129). Radiographic markers were placed on ends of the grafted tendon to assess changes in length and passive excursion. The mean length of the grafted tendon and mean passive excursion were 68.2 mm and 4.4 mm immediately after tendon grafting, 76.1 mm and 7.1 mm at 1 year postoperatively, and 76.3 mm and 7.3 mm at final follow-up, respectively. The mean elongation of the grafted tendon was 12% and mean increase of excursion was 2.9 mm. We recommend that tension set during extensor tendon grafting should be with the metacarpophalangeal joint of the affected finger in a slightly extended position as compared with adjacent fingers. Level of evidence IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47820587","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}
Pub Date : 2022-06-14DOI: 10.1177/17531934221102666
Gaspard Lebot, Marion Halbaut, C. Chantelot, M. Saab
The aim of our study was to compare the medium-term clinical and functional outcomes of early repair of a complete Zone 2B or 2C transection of the flexor digitorum profundus tendon associated with either the repair of the two slips of the flexor digitorum superficialis tendon, only one slip repaired (the other slip was resected) or no slips repaired (both slips were resected). The outcomes of these three repair techniques were compared based on the total active motion, residual flexion deformity of the proximal interphalangeal joint, Strickland’s formula and Tang classification, Disability of Arm Shoulder and Hand score and complications. The study reviewed 61 fingers (51 patients) at a mean follow-up of 89.5 months. There was no significant difference in finger mobility comparing the three techniques for management of flexor digitorum superficialis. All but one patient returned to work and the DASH score (mean 6.9) suggests that function does not appear to be greatly affected. Level of evidence III
{"title":"Medium-term clinical outcomes of Zone 2B/2C finger flexor tendon repairs: influence of management of flexor digitorum superficialis","authors":"Gaspard Lebot, Marion Halbaut, C. Chantelot, M. Saab","doi":"10.1177/17531934221102666","DOIUrl":"https://doi.org/10.1177/17531934221102666","url":null,"abstract":"The aim of our study was to compare the medium-term clinical and functional outcomes of early repair of a complete Zone 2B or 2C transection of the flexor digitorum profundus tendon associated with either the repair of the two slips of the flexor digitorum superficialis tendon, only one slip repaired (the other slip was resected) or no slips repaired (both slips were resected). The outcomes of these three repair techniques were compared based on the total active motion, residual flexion deformity of the proximal interphalangeal joint, Strickland’s formula and Tang classification, Disability of Arm Shoulder and Hand score and complications. The study reviewed 61 fingers (51 patients) at a mean follow-up of 89.5 months. There was no significant difference in finger mobility comparing the three techniques for management of flexor digitorum superficialis. All but one patient returned to work and the DASH score (mean 6.9) suggests that function does not appear to be greatly affected. Level of evidence III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43965581","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}
Pub Date : 2022-06-01DOI: 10.1177/17531934221101998
A. Anbarasan, T. Takagi, A. Seki, S. Takayama
In this study, we retrospectively reviewed our results of managing the clasped thumb deformity in arthrogryposis multiplex congenita patients with first web space deepening and abductor pollicis brevis (APB) rerouting. Twenty-six thumb deformities in 16 children with a mean age of 6.2 years were treated with a mean follow-up of 89.6 months. Following reconstruction with the Spinner flap, the mean angle of the first and second metacarpal axis (M1M2) showed significant improvement from 42° to 61° indicating a wider first web space, and the postoperative mean angle of the thumb proximal phalanx to its metacarpal axis (M1P1) was reduced from 41° to 18°, indicative of a straighter thumb. Following reconstruction with a double-opposing Z-plasty, the mean M1M2 and M1P1 also improved from 38° to 52° and 18° to 9°, respectively. Rerouting of the APB with first web deepening is an efficient and reproducible procedure in improving thumb position. Level of evidence III
{"title":"Abductor pollicis brevis rerouting and first web deepening for clasped thumb deformity in arthrogryposis multiplex congenita","authors":"A. Anbarasan, T. Takagi, A. Seki, S. Takayama","doi":"10.1177/17531934221101998","DOIUrl":"https://doi.org/10.1177/17531934221101998","url":null,"abstract":"In this study, we retrospectively reviewed our results of managing the clasped thumb deformity in arthrogryposis multiplex congenita patients with first web space deepening and abductor pollicis brevis (APB) rerouting. Twenty-six thumb deformities in 16 children with a mean age of 6.2 years were treated with a mean follow-up of 89.6 months. Following reconstruction with the Spinner flap, the mean angle of the first and second metacarpal axis (M1M2) showed significant improvement from 42° to 61° indicating a wider first web space, and the postoperative mean angle of the thumb proximal phalanx to its metacarpal axis (M1P1) was reduced from 41° to 18°, indicative of a straighter thumb. Following reconstruction with a double-opposing Z-plasty, the mean M1M2 and M1P1 also improved from 38° to 52° and 18° to 9°, respectively. Rerouting of the APB with first web deepening is an efficient and reproducible procedure in improving thumb position. Level of evidence III","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42270638","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}
Pub Date : 2022-05-17DOI: 10.1177/17531934221098916
K. V. Brown, D. Roberts, Matthew j wordsworth, L. Duraku, R. Jose, D. Power, S. Stapley
Upper limb injuries are common in conflict zones. The functions of the upper limb are impossible to replicate with prosthetic replacement and wherever possible attempts should be made to preserve the limb with further secondary reconstruction aimed at restoration of function. Casualty assessment, haemorrhage control and resuscitation are simultaneously undertaken at the receiving medical facility. Primary surgical management involves decontamination and debridement, skeletal stabilization, restoration of vascularity, compartment fasciotomy where indicated and wound temporization with dressings. Operative findings and interventions should be documented and if evacuation of the casualty is possible, copies should be provided in the medical records to facilitate communication in the chain of care. Secondary procedures are required for further assessment and debridement prior to planning reconstruction and definitive fracture stabilization, nerve repair, wound cover or closure.
{"title":"Management of conflict injuries to the upper limb. Part 1: assessment and early surgical care","authors":"K. V. Brown, D. Roberts, Matthew j wordsworth, L. Duraku, R. Jose, D. Power, S. Stapley","doi":"10.1177/17531934221098916","DOIUrl":"https://doi.org/10.1177/17531934221098916","url":null,"abstract":"Upper limb injuries are common in conflict zones. The functions of the upper limb are impossible to replicate with prosthetic replacement and wherever possible attempts should be made to preserve the limb with further secondary reconstruction aimed at restoration of function. Casualty assessment, haemorrhage control and resuscitation are simultaneously undertaken at the receiving medical facility. Primary surgical management involves decontamination and debridement, skeletal stabilization, restoration of vascularity, compartment fasciotomy where indicated and wound temporization with dressings. Operative findings and interventions should be documented and if evacuation of the casualty is possible, copies should be provided in the medical records to facilitate communication in the chain of care. Secondary procedures are required for further assessment and debridement prior to planning reconstruction and definitive fracture stabilization, nerve repair, wound cover or closure.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42741997","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}
Pub Date : 2022-05-16DOI: 10.1177/17531934221097254
S. Sabapathy
{"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}
Pub Date : 2022-05-16DOI: 10.1177/17531934221095472
S. Das De, A. Chin, A. Chong, Mark Edward Puhaindran, S. Sechachalam, L. Teoh
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.
在新加坡，手外科是一门独立的专业，有自己的培训项目已有30多年的历史。就像在许多国家一样，专业化的动力来自于压倒性的临床需求(Pei-Yein等人，2021;Pho and Pereira, 1992;销量,1995)。20世纪60年代和70年代是工业化和快速发展的时期，不可避免地导致毁灭性上肢损伤的增加。卫生部认识到这些伤害需要特殊的专业知识，并开始采取分阶段的办法，将手外科发展成为一门独立的专业。两家三级医院——新加坡总医院(SGH)于1985年和国立大学医院(NUH)于1990年成立了手外科。1990年开始了专门的培训计划，1997年手外科被承认为独立的专科。这篇文章回顾了过去三十年来新加坡手外科专业的发展。
{"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}
Pub Date : 2022-05-16DOI: 10.1177/17531934221095377
Dieuwke C. Broekstra, M. D. de Boer, Jonah Stunt
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).
在手外科研究中，大多数研究，无论是观察性研究还是随机对照试验(RCT)，都旨在找出某个决定因素对特定结果是否存在影响(关联或差异)。这通常使用零假设显著性检验(NHST)来确定，其中p值<0.05被认为是研究结果显著的证据。虽然这种方法被广泛使用，但从一开始就受到批评。批评主要集中在对NHST的滥用上，但也更多地集中在方法本身的概念上。在这篇由两部分组成的文章的第1部分中，我们使用部分基于RCT真实数据的模拟数据集(Broekstra et al.， 2022)，讨论了p值如何被滥用的一些示例。在第2部分中，我们将讨论概念批评并提供一些替代方案的指导。在本例研究中，患桡骨远端骨折的女性按1:1的比例随机分为干预组(石膏+康复方案)和对照组(仅石膏)。干预旨在恢复手功能，使用患者评定手腕评估(PRWE)来测量手功能，这是一种经过验证的患者报告的结果测量方法，用于确定手腕问题患者的手功能，得分范围在0(无问题)到100(严重问题)之间。
{"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}
Pub Date : 2022-05-16DOI: 10.1177/17531934221097015
J. Hobby, D. Herren
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
{"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}
Pub Date : 2022-05-16DOI: 10.1177/17531934221097014
W. Lam
{"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}
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