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Journal of hand surgery (Edinburgh, Scotland)最新文献

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Hand surgery training in the United Kingdom: why it is not a separate speciality 英国的手外科培训:为什么它不是一个单独的专业
Pub Date : 2022-05-16 DOI: 10.1177/17531934221095454
C. Ng, G. Bourke, J. Hobby
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.
在过去的几十年里,英国的手外科已经发展成熟,成为公认的外科亚专业。然而,成为一名手外科医生的培训途径仍然是在整形外科或整形外科等专业的培训途径下开始的。尽管过去曾多次讨论过将手外科作为一个独立的专业发展,并有自己的认证,但这种兴趣并没有得到广泛、持续的热情。这反映了历史、职业和社会因素的复杂相互作用,我们将在本文中对此进行探讨。此外,我们将概述为什么我们支持目前的结构,但会提出可以纳入系统的建议,以帮助培养未来一代的手外科医生。
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引用次数: 0
Celebrating the pioneers in hand surgery 庆祝手外科的先驱
Pub Date : 2022-05-16 DOI: 10.1177/17531934221097254
S. Sabapathy
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引用次数: 0
Hand surgery training in Finland 芬兰的手外科培训
Pub Date : 2022-05-16 DOI: 10.1177/17531934221095037
J. Jokihaara, T. Raatikainen, J. Ryhänen
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.
芬兰对手外科的兴趣始于20世纪50年代,当时一些骨科医生对目前手部损伤治疗的结果不满意,开始通过访问欧洲和美国的手外科先驱来熟悉现代治疗方法。随着芬兰手外科学会(FSSH)的成立,芬兰的手外科培训于20世纪70年代初开始。所有五位创始成员都是骨科和创伤学专家,包括后来的国际手外科学会联合会(IFSSH)手外科先驱,Kauko Solonen, Henry Brummer, Martti Vastamäki和Simo Vilkki。培训是实用的、无组织的,也不会获得任何官方资格。然而,FSSH强烈主张建立官方的手外科专业,就像瑞典和美国一样。美国国家医学委员会(National Board of Medicine)对此表示支持,但这一提议遭到了其他专业的强烈反对,因为他们认为这是对外科领域“不必要的补充”。
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引用次数: 0
Evolution of hand surgery as an independent speciality over three decades: the Singapore model 三十年来手外科作为独立专业的演变:新加坡模式
Pub Date : 2022-05-16 DOI: 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。
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引用次数: 0
Statistics in publishing: the (mis)use of the p-value (part 1) 出版统计:p值的(错误)使用(上)
Pub Date : 2022-05-16 DOI: 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。
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引用次数: 5
Solidarity, support and supply 团结、支持和供应
Pub Date : 2022-05-16 DOI: 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
2022年2月24日,世界目睹了俄罗斯对乌克兰的入侵,引发了最大规模的难民潮之一(估计有450万人),并在士兵和平民中造成了爆炸和弹道伤害的人类灾难。这场冲突的影响影响到我们每一个人,特别是在欧洲。在入侵当天,我们在乌克兰手外科学会联合会(FESSH)学院向他们回家的同事道别,不久之后,FESSH发表了一份声明,以“团结、支持和供应”为中心,向悲剧中的所有受害者表示支持。我们在乌克兰的同事目前正在治疗大量的枪伤和炸伤,往往是在困难的情况下,在某些情况下,面临相当大的个人风险。由于各地区持续不断的冲突,许多人在处理这些伤害方面经验丰富,但有些人经验不足,正在与不熟悉的伤害作斗争。为了提供支持,FESSH和英国手部外科学会(BSSH)建立了一个每周网络研讨会计划,讲座内容包括管理战斗伤害的基础知识,借鉴我们在军队的同事的经验,以及我们乌克兰同事提出的案例讨论(图1)。此外,《华尔街日报》还邀请了一篇分两部分的文章,讨论当代战斗伤害的管理。包括从伯明翰的英国国家中心吸取的经验教训。这些文件将在网上提供,并翻译成乌克兰语。编辑团队从《华尔街日报》中选择了一系列相关文章,我们的出版商SAGE将这些文章开放获取。希望FESSH、BSSH和《华尔街日报》的这些努力,无论多么微小,都能在支持我们的国际同事方面发挥作用。可悲的是,我们的同事似乎越来越不可能加入我们的国际
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引用次数: 0
Unity in hand surgery 手外科的团结
Pub Date : 2022-05-16 DOI: 10.1177/17531934221097014
W. Lam
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引用次数: 0
Hand surgery training in Sweden – bridging the gap between specialities 瑞典的手外科培训-弥合专业之间的差距
Pub Date : 2022-05-16 DOI: 10.1177/17531934221095776
P. Axelsson, S. Farnebo, A. Björkman
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.
瑞典有一个政府资助的医疗保健系统,为其1000万居民提供医疗服务。七所大学附属医院均设有手外科,提供24小时紧急手外科护理和专科治疗。这些科治疗所有严重的手部创伤病例,例如骨折、肌腱损伤、神经损伤和再植,并作为选择性手部手术病例的转介中心,包括先天性畸形、痉挛、神经丛损伤和复杂的手腕重建。轻微的手部创伤和常见的选择性手术由这些手外科处理,但也在矫形外科处理。瑞典手外科学会(SHF)和整形外科学会之间达成了一项全国性协议,规定哪些专科应该治疗哪些急性和选择性手外科疾病。目前,任何整形外科都不治疗手部手术。
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引用次数: 0
Hand surgery training in the United States of America 美利坚合众国的手外科培训
Pub Date : 2022-05-16 DOI: 10.1177/17531934221095677
K. Chung
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.
当Sterling Bunnell博士受美利坚合众国武装部队委托在各军事单位教授手部手术时,手部手术首次被认为是一门独特的专业。在他的指导下,他的许多学生成为了美国手外科专业的创始人。1946年1月,Bunnell博士和其他一群二战归来的外科医生在芝加哥会面,以实现他们将手外科作为一门独特专业的愿景;在这里,美国手外科学会(ASSH)诞生了。这些创始人来自三个不同的外科专业:普通外科、整形外科和整形外科。如今,在美国,手外科培训作为一种研究金途径,在接受了这些核心学科之一的基础教育后,被纳入了这些专业。在随后的几年里,开发了许多新技术,如骨折的刚性固定、关节置换手术、促进再植和皮瓣手术的显微外科、手腕手术和关节镜检查。这些进步带来的挑战是培训一名全面的手外科医生,他能够进行复杂的创伤护理,能够对手部损伤进行复杂的显微外科手术,以及先进的骨固定程序。此外,神经外科的发展需要手外科医生了解周围神经的解剖和生理学,以解决从臂丛神经到指神经的有趣问题。
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引用次数: 0
Exploration of rehabilitation through the use of virtual reality interventions for patients with hand conditions: a scoping review 通过对手部疾病患者使用虚拟现实干预进行康复的探索:范围界定综述
Pub Date : 2022-05-10 DOI: 10.1177/17531934221098504
Stefanie Frances Gibb Née Andrew, C. Clark, Z. Sheppard, T. Crook
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.
在过去的十年里,使用虚拟现实来帮助手部和上肢疾病的康复是一个新兴领域。该领域的大多数研究都集中在神经疾病上,例如中风后,通过各种机器人和数字技术改善手部功能方面取得了重大进展。尽管虚拟现实康复技术取得了进步,但在目前的实践中,它并不容易用于手部或上肢疾病。最近的新冠肺炎危机,以及一些人在家接受康复的要求和/或偏好,突出了开发这项技术的重要性,使其成为标准实践的一部分。本范围审查旨在探索手部康复中的沉浸式虚拟现实研究。目标是确定当前技术的优势和劣势,并强调任何知识差距,为未来的研究提供信息。
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引用次数: 0
期刊
Journal of hand surgery (Edinburgh, Scotland)
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