Federation Of Societies For Surgery Research Articles

Wassel Type IV Thumb Duplication A Case Report and Literature Review

Thumb polydactyly, also known as radial polydactyly, is the prevailing manifestation of polydactyly. Its existence has been documented in the hand literature from Digby's initial description in 1645. Preaxial polydactyly, specifically bifid thumb, has been extensively observed, with a frequency ranging from 0.08 to 1.4 per 1000 live births. Traditionally, radial polydactyly is classified into three distinct categories: severe hypoplasia, partial duplication, and entire duplication, which can sometimes be mistaken for pseudo duplication. The classification system developed by Wassel has emerged as the widely accepted standard for the categorization of thumb polydactyly. The classifications of surgical treatment procedures are associated with variations. Thumb duplication is categorized as a "duplication" (group 3) in the International Federation of Societies for Surgery of the Hand (IFSSH)/Swanson classification of congenital malformations of the hand and upper limb. The objective of surgical reconstruction is to achieve a thumb that is both stable and mobile, while also possessing appropriate dimensions and form. The prevailing method of reconstruction often involves the excision of the minor digit followed by the subsequent reconstruction of the major digit. Surgical procedures aim to rectify issues pertaining to deviation, instability, and insufficient dimensions. Moreover, it is worth noting that a significant proportion of instances will necessitate an additional intervention in order to enhance the cosmetic and/or functional result.

Geographical differences in carpometacarpal joint osteoarthritis treatment of the thumb: A survey of 1138 hand surgeons from the USA and Europe

Carpometacarpal osteoarthritis of the thumb (CMC OA) is treated with various therapeutic approaches. However, the literature remains inconclusive regarding the ideal procedure for each disease stage. In this study, we assessed the international application of surgical treatment options including CMC I implants and non-surgical treatment options for CMC OA depending on the disease stage, with a strong focus on the detection of geographical disparities. We conducted a large international online survey with members of hand surgical societies of the International Federation of Societies for Surgery of the Hand (IFSSH). The first part of the survey asked about general therapy options of CMC OA depending on the severity of the disease, whereas the second part specifically dealt with the use of prostheses. We could include 10 of 56 IFSSH member societies (6807 surgeons) and received answers from 1138 members (16.7%). Significant differences were detected in an increased use of corticosteroid injections in the USA, and a growing frequency of fat injections in Europe. Regarding use and frequency of the resection arthroplasty, we found similar results in all participating countries. Prosthetic implantation showed a significant difference between the USA and Europe, with far larger numbers stated by European hand surgeons. CMC OA is treated differently in the participating countries depending on the stage of the disease. We give an insight into geographical differences in treatment paradigms, with corticosteroid injections being more prevalent in the USA, and prosthesis implantation being more frequently chosen in the selected European countries.

Report of the 12th Asian Pacific Federation of Societies for Surgery of the Hand and 8th Asian Pacific Federation of Societies for Hand Therapy Congress Melbourne, Australia 2020.

Report of the 12th Asian Pacific Federation of Societies for Surgery of the Hand and 8th Asian Pacific Federation of Societies for Hand Therapy Congress Melbourne, Australia 2020.

Oberg-Manske-Tonkin Classification of Congenital Upper Extremity Anomalies: The First Report From Turkey.

Although the Oberg-Manske-Tonkin (OMT) classification has been recommended by the International Federation of Societies for Surgery of the Hand owing to some insufficiencies of the Swanson classification system, it has not achieved a universal adoption by hand surgeons. In this study, we hypothesize that the OMT classification can be used easily to classify congenital upper extremity anomalies. We also aim to make epidemiological analysis of congenital upper extremity anomalies with the OMT classification and to compare the applicability of the OMT and the Swanson classifications. We retrospectively analyzed 711 patients and 833 extremities operated on between 2012 and 2017. Photographs, plain x-rays, and brief medical histories of the patients were evaluated by 4 plastic surgeons. Two independent evaluations were made by each surgeon in 1-month interval using these classification systems. Total number of upper extremity anomalies recorded was 1050. Of the 711 patients operated on, 122 had bilateral anomalies. The anomalies were identified in 833 extremities because many extremities had more than a single diagnosis. We were able to classify all of the anomalies within the OMT classification. The OMT classification gives better reliability results compared with the Swanson classification according to intrarater and interrater reliabilities. Compared with the Swanson classification system based on phenotypic evaluation of the extremity, the OMT classification system is easier to apply and the association of the anomaly with the embryologic origin during evaluation is possible. We believe that multiple studies from different centers will boost the international acceptance of the OMT classification.

Research activity among European hand surgery residents.

During residency, most hand surgeons may be encouraged to participate in clinical or basic science research projects. The research committee of the Federation of European Societies for Surgery of the Hand (FESSH) is dedicated to support research activities, especially of young surgeons, including residents. In 2018, we initiated a survey among European hand surgeons to assess hurdles that limit research activity during hand surgery training and to explore if FESSH can take a more active role in promoting research activities.

Classification of congenital upper limb anomalies: towards improved communication, diagnosis, and discovery.

Recently the International Federation of Societies for Surgery of the Hand replaced the Swanson scheme for classifying congenital upper limb anomalies with the Oberg, Manske, Tonkin (OMT) classification. This review explores the reasons for this change after nearly 50 years of using the Swanson classification. In particular, it documents the state of our understanding regarding genetics and limb development at the time Swanson generated his classification. It also describes the continued progress in clinical genetics and developmental biology. Such progress drives the need to embrace and incorporate these changes within a new classification scheme; one that will improve communication, diagnosis, and support further discovery of the pathogenesis of congenital hand anomalies.

Report on the 11th Asian Pacific Federation of Societies for Surgery of the Hand (APFSSH).

Report on the 11th Asian Pacific Federation of Societies for Surgery of the Hand (APFSSH).

The outcome of primary brachial plexus reconstruction in extended Erb\u2019s obstetric palsy when only one root is available for intraplexus neurotization

BackgroundA recent review by the International Federation of Societies for Surgery of the Hand showed no studies comparing the results of nerve grafting to distal nerve transfer for primary reconstruction of the brachial plexus in infants with obstetric brachial plexus palsy (OBBP). The aim of this retrospective study is to compare two surgical reconstructive strategies in primary reconstruction of the brachial plexus in extended Erb’s obstetric palsy with double root avulsion: one with and one without distal nerve transfer for elbow flexion.MethodsTwo groups of infants with extended Erb’s palsy and double root avulsion were included in the study. Group I (n = 29) underwent reconstruction of the brachial plexus without distal nerve transfer. In group II (n = 26), the reconstruction included a distal nerve transfer for elbow flexion.ResultsBoth groups had an excellent (over 96%) satisfactory outcome for elbow flexion. Group II has a significantly better outcome (P < 0.05) of shoulder abduction and wrist extension than group I.ConclusionsThe use of a distant nerve transfer for bicep reconstruction in extended Erb’s obstetric palsy with double root avulsion gives a better outcome for shoulder abduction and wrist extension; and this seems to be related to the availability of more cable grafts to reconstruct the posterior division of the upper trunk and the middle trunk.Level of Evidence: Level III, therapeutic study

Report of the 10th Asia-Pacific Federation of Societies for Surgery of the Hand Congress (Organising Chair and Scientific Chair)

A report on the 10(th) Asia-Pacific Federation of Societies for the Surgery of the Hand and 6(th) Asia-Pacific Federation of Societies for Hand Therapists is submitted detailing the numbers of attendees participating, papers presented and support received as well the some of the challenges faced and how best to overcome them from the local conference chair and scientific chair point of view.

The OMT Classification of Congenital Anomalies of the Hand and Upper Limb.

The Oberg, Manske and Tonkin (OMT) Classification of congenital anomalies of the hand and upper limb uses dysmorphological terminology, placing conditions in one of three groups: Malformations, Deformations and Dysplasias. The main group, Malformations, is further subdivided according to whether the whole of the limb is affected or the hand plate alone, and whether the primary insult involves one of the three axes of limb development and patterning or is non-axial. The common surgical diagnoses, such as thumb duplication and thumb hypoplasia, are then placed within this framework. Recently the International Federation of Societies for Surgery of the Hand Scientific Committee for Congenital Conditions approved the OMT Classification as a timely and appropriate replacement of the previously accepted Swanson Classification. This review charts the development of and modifications to the OMT Classification and its current status.

Ghazi M Rayan and Joseph Upton III: Congenital Hand Anomalies and Associated Syndromes

The book starts with a reminder from the 1982 Lamb study, of a birth incidence for upper limb malformations of 11 per 10,000 live births, 51 % being bilateral and 17 % associated with multiple malformations. Limb defects are more prevalent in boys, with pre-term, post-term and multiple births, and in the offspring of older mothers. Classifications are based on those of the American Society for Surgery of the Hand and the International Federation of Societies for Surgery of the Hand. The classification encompasses several categories, including failure of formation, defective differentiation, duplication, undergrowth and overgrowth, constriction bands and general skeletal anomalies. This classification blends well with our current understanding of the aetiology of limb defects. The book covers aetiology only minimally but briefly alludes to the key molecular mechanisms. Given the rapid pace of progress in understanding the molecular genetics of limb development, it would be difficult for a text book to remain in date and therefore appropriate for the reader to look elsewhere. I would strongly recommend this as an educational resource to understand the use of specific terms describing hand malformations and as a practical tool to aid with diagnosis of hand anomalies. The resource of photographs is unique. This is a long-awaited comprehensive review of congenital hand anomalies and associated syndromes that will appeal to clinical geneticists and hand surgeons alike. The illustrations are outstanding, with a combination of photographs, X-rays, illustrative diagrams, plaster moulds and CT scans. As this was written by two hand surgeons, the clinical genetics reader may find some of the surgical photographs unsettling, but they are helpfully linked to pre-operative photographs and serve a purpose reminding us of the internal anatomy of the limb and how this, too, may be abnormal. There are descriptions of 127 associated syndromes and 37 congenital differences. Although this is a highly specialised field, the breadth of conditions covered alludes to the high frequency of limb anomalies in genetic syndromes. Syndromic descriptions include photographs of the syndromologist, hallmarks, background, aetiology and presentation, and a list of associated anomalies. A clear systematic approach is used with Chapters 1 subdivided into tumours, enchondromas, osteochondromas, neurofibromas, vascular malformations, congenital contractures, and congenital joint laxity/instability. Chapters 2 and onwards are classified by the anatomical location (elbow, forearm, hand, thumb, digits, and skin).

Epidemiology of Congenital Upper Limb Anomalies in Stockholm, Sweden, 1997 to 2007: Application of the Oberg, Manske, and Tonkin Classification

To investigate the epidemiology of congenital upper limb anomalies (CULA) based on the newly proposed Oberg, Manske, and Tonkin (OMT) classification, to compare this classification with the International Federation of Societies for Surgery of the Hand (IFSSH) classification, and to provide incidence rates of the different CULA. In this study, the same 562 individuals with a CULA who were analyzed in a previous epidemiologic study based on the IFSSH classification were reclassified according to the OMT classification. All children identified with CULA and born in Stockholm County between January 1, 1997 and December 31, 2007 were included in the study. During the period there were 261,914 live births in Stockholm County, and the population of Stockholm County was 1,949,516 inhabitants at the end of the period. From medical records and available radiographs, all cases were analyzed regarding type of CULA, sex, affected side, associated nonhand anomalies, and occurrence among relatives. Individuals with right and left side anomalies belonging to different OMT subgroups were counted as 2 anomalies; thus, the material consisted of 577 CULA in 562 children. It was possible to organize all CULA into the OMT classification. The largest main category was malformations (429 cases), followed by deformations (124 cases), dysplasias (10 cases), and syndromes (14 cases). We present the relation between the IFSSH and OMT classifications, elucidate difficulties within the OMT classification, and propose additions to the classification. This study confirms that the OMT classification is useful and accurate, but also points out difficulties. With further refinements, we regard the OMT classification as a needed and appropriate replacement for the IFSSH classification. Diagnostic III.

The Role of the FESSH Hand Trauma Committee in Europe

In Europe the need for clear definitions of hand surgery facilities regarding trauma is becoming really important to guarantee a correct and up-dated treatment of lesions more and more frequent and complex. The goal for European patients should be to have similar treatment based on appropriate referral and assistance in centres officially accredited for hand surgery. The target for the European countries, giving the correct support to the centres and surgeons treating these problems, should also be to save the costs of residual invalidities. These are some of the reasons for the European Federation of Societies for Surgery of the Hand (FESSH) decided to form a committee (Hand Trauma Committee) devoted to study this problem, trying to give common guidelines and forming an European net of accredited centres. The first step was to collect data through a network of national representatives. Covering a 487 millions population, 309 centres were recorded, including 1 797 surgeons and 20 363 patients treated during January 2006, then having a clear situation of hand trauma treatment through Europe. Next, the HTC worked on 3 definitions: hand trauma, hand trauma surgeons and hand trauma centres and started to accredit centres applying to these well defined criteria. The HTC is now working on scientific consensus on some traumatic lesions but also on the important topic of prevention of hand traumas. This work is expected to improve an homogenous situation throughout Europe focusing on the better use of the given resources for the prevention and the treatment of these traumatic lesions.

S. Raja sabapathy.

Dr. Raja Sabapathy is the Chairman of the Department of Plastic Surgery, Hand and Reconstructive Surgery and Burns at Ganga Hospital, Coimbatore, India. He graduated from Stanley Medical College in Madras, India, as the Best Outgoing Student in 1979. He did his plastic surgery residency at the same institution, and later trained for 2 years at the Stoke Mandeville Hospital and the Canniesburn Hospital in the United Kingdom. He did his Hand Fellowship at the Kleinert Institute in Louisville, Kentucky in 1989–1990. Upon his return to Coimbatore, he developed the unit at Ganga Hospital, which has since emerged as one of the premier trauma reconstructive and replantation surgical centers in South Asia. His main interests are hand surgery and reconstructive microsurgery. In 2005, he delivered the Douglas Lamb Lecture of the British Society for Surgery of the Hand on Major Replantations at the Royal College of Surgeons. He has held the presidencies of the Indian Society for Surgery of the Hand, the Indian Society for Reconstructive Microsurgery, and the Association of Plastic Surgeons of India. He was the Organizing Chairman of the 12th Congress of the International Federation of Societies for Surgery of the Hand held in New Delhi, India in March 2013. Dr. Sabapathy has put together a superb group of experts for this issue. I want to thank him for his hard work serving as the guest editor of this excellent edition of Seminars.

Multinodular/plexiform schwannoma of the ulnar nerve

ANZ Journal of SurgeryVolume 84, Issue 1-2 p. 93-94 IMAGES FOR SURGEONS Multinodular/plexiform schwannoma of the ulnar nerve Chiao Yee Lim MBBS, Chiao Yee Lim MBBS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorTze Hau Low MS, Tze Hau Low MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorRuban Sivanoli MS, Ruban Sivanoli MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorKok Kheng Teh MS, Kok Kheng Teh MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorRavindran Thuraisingham MS, Ravindran Thuraisingham MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this author Chiao Yee Lim MBBS, Chiao Yee Lim MBBS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorTze Hau Low MS, Tze Hau Low MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorRuban Sivanoli MS, Ruban Sivanoli MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorKok Kheng Teh MS, Kok Kheng Teh MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this authorRavindran Thuraisingham MS, Ravindran Thuraisingham MS Department of Orthopaedic Surgery, University Malaya Medical Centre, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Kuala Lumpur, MalaysiaSearch for more papers by this author First published: 28 October 2013 https://doi.org/10.1111/ans.12231 This paper is funded by University Malaya Research Fund Assistance. The abstract has been presented as a poster at the 9th Congress of Asian Pacific Federation of Societies for Surgery of the Hand (APFSSH), 10th–13th October 2012, Bali, Indonesia. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume84, Issue1-2January-February 2014Pages 93-94 RelatedInformation

Asian-Pacific Federation of Societies for Surgery of the Hand

Asian-Pacific Federation of Societies for Surgery of the Hand

A New Documentation System for Congenital Absent Digits

Congenital absent digits continue to be described by many confusing terms and are currently classified in categories I, V, and VI of the International Federation of Societies for Surgery of the Hand classification and seven subclassification systems. Very few classification systems provide any logical basis for surgical reconstruction. The purpose of this study was to develop a simple alphanumerical documentation system to reproducibly describe the morphological or radiographic appearance of congenital absent digits and facilitate communication of these childrens' hand anomalies from one hand surgeon to another. Dorsal and palmar photographs and PA radiographs of 235 hands in 204 children born with congenital absent digits over a 15-year period were analyzed to determine which digital rays were missing and their level of absence. Each hand can be described by three letters, R (radial), C (central), and U (ulnar), as well as numbers 1-5. The first letter and number designate which rays are missing and the second and third letters and numbers designate which rays remain present. There are 15 morphological phenotypes of congenital absent digits. The three most common phenotypes are U4R1 (a thumb but absence of all four fingers), R1U4 (absent thumb), and R5 (aplastic hand). This new documentation system allows hand surgeons to describe the simple morphological or radiographic appearance of congenital absent digits; incorporates all the previous subclassification systems that have attempted to describe congenital absent digits in radial, central, and ulnar deficiencies, symbrachydactyly, and congenital constriction ring syndrome; and has subsequently allowed the development of an algorithm which predicts whether conventional or microsurgical reconstruction is indicated for each specific phenotype.

Congenital Upper Limb Deficiencies and Associated Malformations in Finland: A Population-Based Study

To calculate the national incidence of upper limb deficiencies and associated infant mortality in children in Finland using the International Federation of Societies for Surgery of the Hand (IFSSH) classification. Radial ray deficiency, ulnar ray deficiency, central ray deficiency, transverse arrest, phocomelia, undergrowth, and constriction band syndrome with skeletal defects were evaluated. We reviewed upper limb deficiencies among all 753,342 births in Finland during 1993 to 2005 reported to the Finnish Register of Congenital Malformations. Classification of these upper limb deficiencies was done according to a modified IFSSH system. We calculated incidence, gender and side distributions, frequency of associated anomalies, and infant mortality rates in different subtypes of the deficiencies. Familial occurrence of congenital upper limb defects was recorded. A total of 419 cases (234 male, 185 female) of upper limb deficiencies were identified. The national incidence of upper limb deficiencies was 5.56 per 10,000 births and 5.25 per 10,000 live births. The most common upper limb abnormality was radial ray deficiency (138), followed by subgroups of undergrowth (91), upper limb defects due to constriction band syndrome (51), central ray deficiency (41), and ulnar ray deficiency (33). Perinatal mortality was 14%. Infant mortality among children with upper limb deficiencies was 137 per 1,000 live births, compared with an overall infant mortality of 3.7 per 1,000 live births in Finland. Additional birth defects were found in 60% of these children. Prevalence of upper limb defects in relatives of the census population was 2% (11 of 419). The national incidence of upper limb deficiencies is 5.25 per 10,000 live births. Congenital upper limb deficiencies are associated with additional birth defects in two thirds of cases. These children, especially children with radial ray deficiency, have a high perinatal mortality rate. When divided into subgroups using IFSSH classification, differences emerge in both associated anomalies and mortality.

Epidemiology of Congenital Upper Limb Anomalies in 562 Children Born in 1997 to 2007: A Total Population Study from Stockholm, Sweden

There are few true epidemiological studies of congenital anomalies of the upper limb (CULA) on total populations in the literature, and most incidence studies are hospital based. The purposes of this study were to describe the epidemiology and classify all CULA in a region of Sweden during an 11-year period. Between 1997 and 2007, there were 261,914 live births in the Stockholm region. A total of 562 children born during this period were found to have CULA. From medical records and available radiographs, all cases were analyzed regarding the type of congenital anomaly, gender, laterality, occurrence among relatives, associated non-hand anomalies, and syndromes. All 585 main anomalies were classified according to the International Federation of Societies for Surgery of the Hand classification. Individuals with right- and left-side main anomalies belonging to different categories were counted as having 2 anomalies. The recorded incidence of CULA was 21.5 per 10,000 live births. Of the 562 children, 304 were boys. The anomalies affected the right side only in 169 children, the left side only in 186, and both sides in 207. Non-hand anomalies were recorded in 129 children, most commonly in the lower limbs. In 99 children, there was a known occurrence among relatives. Failure of differentiation was the most common category (276 of 585) followed by duplication (155 of 585), failure of formation (103 of 585), undergrowth (18 of 585), generalized abnormalities and syndromes (14 of 585), overgrowth (10 of 585), and constriction ring syndrome (9 of 585). The incidence of CULA in our region was similar to the only previously comparable total population study from Western Australia. The minor differences in incidences between the categories according to the International Federation of Surgical Societies of the Hand may be due to variations in classification strategy. The results of the present study can be used as a reference of CULA in a total population.

Occurrence of Central Polydactyly, Syndactyly, and Cleft Hand in a Single Family: Report of Five Hands in Three Cases

Central polydactyly, syndactyly, and cleft hand are categorized separately in the International Federation of Societies for Surgery of the Hand classification. However, some investigators have proposed that these malformations should be classified into a single category: abnormal induction of finger rays. In this article, we report 5 hands with central polydactyly, syndactyly, and cleft hand in 3 patients from the same family and discuss the phenotypes in each hand.