Asian Pacific Federation of Societies for Surgery of the Hand

The discussions which finally led to the formation of the Asian-Pacific Federation of Societies for Surgery of the Hand (APFSSH) were conducted in Hong Kong on the 30^th April and 1^st May, 1994. Representatives of all founding societies, except India, were present at these meetings during which the name of the Federation and its objectives were established. A tentative structure was established with aDelegates’ Council, consisting of representatives from each prospective member society, and an acting Executive Committee, with appointments to be confirmed at a the next official Council meeting after individual member societies had accepted a formal invitation to join the Federation.

The decision to establish the Federation and the recommendations of the discussion group in Hong Kong were born of a prolonged gestational period. As early as 1979, Dr BB Joshi from India organised an "Afro-Asian Hand Meeting" and advocated the development of a regional hand surgery group. He may not have been the first to suggest this. Regrettably, APFSSH archives do not provide a detailed and precise history of all those who contributed to the development of a regional Federation. The Western Pacific Orthopaedic Association was established in 1962, changing its name to the Asia-Pacific Orthopaedic Association in 2000. Within this association was a hand surgery group. This could be considered as the forerunner of the current Federation. In late 1990, Michael Tonkin from Australia wrote to Asian-Pacific member societies of the International Federation of Societies for Surgery of the Hand (IFSSH), advocating the formation of a regional Federation. By this time the European Federation of Societies for Surgery of the Hand (FESSH) had been established, following preliminary meetings in 1989 when a draft constitution was agreed upon and subsequently adopted in Paris on the 11th February, 1990. The largest of the IFSSH member societies was the American Society for Surgery of the Hand (ASSH), which was closely aligned geographically with Canada and the South American countries. It appeared appropriate for the Asian-Pacific countries to align as they formed a natural geographic region. Some considered that the effective function of such a Federation would be very difficult because of budgetary, geographical and cultural differences amongst the probable constituent societies. These were also problems which confronted the European societies when establishing the European Federation.

Robert Pho from Singapore and Tatsuya Tajima from Japan communicated regarding the structure a regional group, its name and its probable membership. Discussions continued at the IFSSH Paris meeting in 1992 and subsequently the 1994 Hong Kong discussion was organised at a Western Pacific regional education hand surgery programme, conducted by the Hong Kong Society for Surgery of the Hand with the encouragement of the IFSSH, who had appointed Tatsuya Tajima as the Chairman of the Western Pacific Regional Education Programme.

The APFSSH acting Executive Committee formed at that meeting consisted of President Tatsuya Tajima (Japan), Vice-President (President-Elect) Wayne Morrison (Australia), Treasurer Timothy So (Hong Kong) and Secretary Lam-ChuanTeoh (Singapore). Lam-ChuanTeoh, with the other members of the Executive Committee drafted an invitation to societies of the region. They established a Charter for consideration of adoption at a Council meeting to be held in Singaporeon the 19^th and 20^th January, 1995. At this meeting an amended Charter was adopted by the foundation society members and the members of the acting executive council were confirmed in their positions.

The founding APFSSH societies were those from Australia, Hong Kong, India, Indonesia, Japan, Korea (two societies), Malaysia, New Zealand, Philippines, Singapore, Taiwan and Thailand. The objective of the Federation as defined in the Charter:

Article II – Objective
This organization is formed for the purpose of promoting the practice of hand surgery and coordinating the activities of the various societies for surgery of the hand in the Asia-Pacific region. Its main purposes shall be:

• to maintain liaison and communication between the various societies,
• to promote the free exchange of knowledge amongst constituent societies,
• to enhance the opportunity of hand surgery training through friendly exchange programs,
• to disseminate knowledge through publications,
• to enhance teaching by organizing scientific meetings and regional instructional courses.

Amendments to the Charter, adopted in 1995, were accepted in August 2000 at the 4^th Council Meeting in Chennai.

The first APFSSH Congress was conducted in Perth, Australia, in March 1997 with Mark Allison and Michael Tonkin as convenors, Bruce Conolly as the President of the Australian Hand Surgery Society and Tatsuya Tajima as the inaugural APFSSH President. Subsequent congresses have been conducted in Singapore, Chennai, Seoul, Osaka, Bangkok, Hong Kong, Kaohsiung, Bali, Kaula Lumpur, Cebu, Melbourne, with the next congress to be hosted by the Singapore Society in 2023.

The Tajima Lecture was established in 2004 to recognise the contribution to hand surgery of the inaugural APFSSH President, Tatsuya Tajima from Japan. The current APFSSH President has the responsibility of nominating the Tajima Lecturer for each Congress. Those who have been honoured by this invitation are Lam-Chuan Teoh (Bali, 2012), Kazuteru Doi (Kaula Lumpur, 2014), Aiko Minami (Cebu, 2017) and Wayne Morrison (Melbourne, 2020).

At the 2020 Melbourne Meeting, a new Plenary lecture was introduced with the title 'Presidential Guest Lecture' with the plans to make it an annual feature. Raja Sabapathy delivered the inaugural Presidential Guest Lecture on the title, "Building an Institution and Beyond".

Hand Surgery, the official journal of the APFSSH has developed in parallel with the Federation. The first volume was published in January 1996 under the guidance of Editor-in-Chief S.P. Chow from Hong Kong, who could be considered as the "father" of the journal. S.P. Chow attracted funding from a colleague in the business world and negotiated with World Scientific Publishing in Singapore to produce Hand Surgery under financial arrangements which were feasible for a fledgling Federation.

The editorial office moved from Hong Kong to Japan, under the direction of Yoshikazu Ikuta (2003-2009) and subsequently with Akio Minami as the Editor-in-Chief (2009-2014). Michael Tonkin (Australia) and MoroeBeppu (Japan) have assisted the editorial office as co-Editors Goo Hyun Baek from Korea took overas Editor-in-Chief in 2015 with Raja Sabapathy, Alphonsus Chong, Hiroyujki Kato and HS Gong joining the enlarged board of Deputy Editors.To start with three issues of the journal werepublished yearly, and as of 2020 four issues are published yearly. By 2021 it is planned to move to six issues per year. Subscription numbers in 2011 are over 1200. The development of this journal has been a significant task, the brunt of which was borne initially by the Hong Kong Society initially, then by the Japanese Society. Well established, it is a forum for the publication of the work emanating from the Asian-Pacific region, not yet matching the standards of the European and American journals of Hand Surgery but rapidly improving in quality and sophistication.

By 2017 the need for having a permanent office for the APFSSH for its further growth was felt. At the Philippines APFSSH meeting, the delegates deliberated on the subject and narrowed down the choice to Singapore. President Goo Hyun Baek, President Elect Raja Sabapathy and the Secretary General Anthony Berger collaborated with our colleagues in Singapore particularly Alphonsus Chong and SandeepSebastin in drafting a constitution complying to the laws of Singapore for registration of APFSSH as a not-for-profit organization. Due to theirsustained effort, APFSSH is now a registered Federation withheadquarters at Singapore. The newly drafted constitution also helped to expand the executive council with the provision to take in Members-at-large. A bank account for the Federation has been started, the first one for it with the Development Bank of Singapore. Hong Kong Society for Surgery of the Hand provided the first major deposit when they transferred the surplus of the APFSSH meeting held in Hong Kong in 2008.

In November 2009, at the Kaoshiung APFSSH Congress, an APFSSH Travelling Fellowship Scheme Management Committee was appointed with a view to establishing an APFSSH Visiting Professorship and APFSSH Travelling Fellowships. These developments, and others, are a part of the next chapter of the history of hand surgery in the Asian-Pacific region, which includes increasing the number of member societies in the Federation.These and other educational initiatives will become possible due to the setting up of the permanent secretariat.

The future of APFSSH appears bright, with an expanded vibrant council, increasing member nations and with definite plans to meet the goals of the Federation.