Hand surgery training in Sweden – bridging the gap between specialities

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.