Association of Hand Surgeons of the Philippines (AHSP)

Hand surgery in the Philippines began with two premier orthopaedic institutions: The National Orthopaedic Hospital (now the Philippine Orthopaedic Center) and the Department of Orthopaedics at the Philippine General Hospital, University of the Philippines.

In 1956, the Hand and Peripheral Nerve Surgery Unit was established at the National Orthopaedic Hospital with Dr. Buenaventura Canto as head and Dr. Eugenio Inocentes Jr. as the senior resident. Three years later, through the efforts of Dr. Canto and Dr. Benjamin Tamesis, Dr. Inocentes was sent to the United Kingdom and India from 1959 to 1960 under the British Colombo Plan Fellowship Grant. Dr. Inocentes rotated under Dr. RG Pulvertaft, Prof. HJ Seddon and Dr. D Brooks in England, Prof. JP James in Scotland, and Prof. PW Brand in India. After his return to the Philippines in 1960, he headed the Hand and Peripheral Surgery Unit

At the other end of the capital city of Manila, the University of the Philippines College of Medicine-Philippine General Hospital (PGH) established in 1952, the Section of Orthopaedics under Dr. Ambrosio Tangco under the Department of Surgery. Dr. Tangco sent a promising surgeon Dr. Jose V. Silao, Jr. for hand surgery training in the USA under Dr. Robert E. Carroll from 1970-71. In June 1971, the Section of Orthopaedics became a separate Department, with Dr. Jose V. Silao, Jr. as first Department Chairman. Dr. Silao formed the different sections of Orthopaedics, which included the Section of Hand Surgery. In 2002, the Section of Hand Surgery established the Microsurgery Service and in 2005, the Microsurgery Service was renamed the Microsurgery Unit-a multidisciplinary unit dedicated to microsurgical reconstruction needs of patients. To this day, the Section of Hand and Reconstructive Surgery of the Department of Orthopaedics, University of the Philippines Manila is the only training institution in the country with a clinical fellowship in hand surgery which started way back in 1995.

The Philippine Society for Surgery of the Hand (PSSH)

In 1970 Dr. Vicente Pido, a 1962 UST medical graduate, who obtained his orthopaedic residency training at Carney and Boston City General Hospital and his hand training at Massachusetts General Hospital (1969) came back to the Philippines. He also completed a course in microsurgery at the Tokyo Jikej-Kai Hospital under a Takeda Foundation in 1976. In 1985, through his initiative and efforts he met with and was able to convince the hand-trained NOH and UP-PGH staff, to organize a hand society to address the needs of the Filipino people for specialized care of the hand, which after several meetings, was finally established in 1986 as “The Philippine Society for Surgery of the Hand”, now known as the Association of Hand Surgeons of the Philippines (AHSP). The founding officer and members of the society were:

AHSP Members

Standing (L-R): Dr. Leo Daniel Caro, Dr. Miguel Pagsaligan, Dr. Vicente Castillo, Dr. Lucille Detoyato, Dr. Frederick Montaño, Dr. Eugene Brito, Dr. Lito Gozum, Dr. Luisito R. Maaño, Dr. Ida Tacata, Dr. Giselle Gabriel, Dr. Tristram Montales, Dr. David Alagar, Dr. Nestor Lim, Dr. Lito Bautista, Dr. Noel Carilo

Sitting (L-R): Dr. Emmanuel Estrella, Dr, Ameena Santos, Dr. Peachy Handog, Dr. Nathaniel Orillaza Jr, Dr. John Hubert Pua, Dr. Raymar Sibonga, Dr. Brian Dormitorio, Dr. Jessica Gadionco

Congress Banquet 11th APFSSH and 7th APFSHT 2017 Meeting in Cebu, Philippines

From then on the society started bi-monthly meetings and occasionally sponsored symposiums with members as lecturers in some regional areas in cooperation with local POA (Philippine Orthopaedic Association) and PCS (Philippine College of Surgeons) groups, aside from having invited foreign guest speakers during POA Annual Conventions. The society is a member of the Asian-Pacific Federation of Societies for Surgery of the Hand.

In November 2017, the AHSP hosted the 11th APFSSH (Asian Pacific Federation of Societies for Surgery of the Hand) in Cebu City, Philippines. This was a historic event for Philippine Hand Surgery since this was the first time that the Philippines hosted an international Hand Congress. Over four hundred participants from 25 countries attended the said event. Leading hand surgeons from the Asia Pacific region and around world shared their expertise in hand and microsurgery.

The following served as President of the AHSP after Dr. Vicente Pido:

The society has expanded its membership to 43 hand surgeons from Orthopaedic, General and Plastic Surgery. The Association of Hand Surgeons of the Philippines (AHSP) is the official specialty society, under the Philippine Orthopaedic Association and the Philippine College of Surgeons, composed of specialists, trained and passionate in improving care for the hand and upper limb of the Filipino people. Underrepresented among medical professionals in the country, the association bands together practicing hand specialists in order to foster a community of mutual cooperation and professional development with the ultimate goal of improving patient care.

Post- graduate course for Orthopaedic Resident Training organized by the AHSP.

(L-R) Dr. Ida Tacata, Dr. Lito Bautista, Dr. Lito Gozum, Dr. Leo Daniel Caro, Dr. John Capo, Dr. Nathaniel Orillaza Jr.

Today, the AHSP continues its advocacy to provide proper management for various conditions of the hand with its members across the archipelago. The society also disseminates knowledge through scientific meetings, lectures and workshops to enhance the study and practice of hand and upper limb care in the country. Enhanced by dynamic social media platforms, the society aims to reach and teach the people preventive measures and enhanced health-seeking behaviour in order to prevent loss of function, carry out timely treatment, achieve better outcomes and avoid complications in problems involving the hand.

In Vitro Comparison between the Pulvertaft Weave and the Modified Core Suture Pulvertaft Weave.
Van Royen K, Quintero JI, Voor M, Muneer M, Bouri F, Muresan C, Tsai TM. J Hand Surg Asian Pac Vol. 2021 Sep;26(3):377-382.

'Complimentary access to full text of this article has been provided by the World Scientific Publishing Co. (Singapore) and requires registration at the journal website. Registration is free.'

This study is an in-vitro analysis of two tendon reconstruction techniques. The first is a more classic version of the Pulvertaft weave technique, whereas the second is a modification to this technique, adding some of the principles of multistrand flexor tendon repair. The results show a significant increase in stiffness, first failure load and ultimate failure load for the core suture weave technique.

A Comparison of Splint Versus Pinning the Distal Interphalangeal Joint for Acute Closed Tendinous Mallet Injuries.
Nagura S, Suzuki T, Iwamoto T, Matsumura N, Nakamura M, Matsumoto M, Sato KA. J Hand Surg Asian Pac Vol. 2020 Jun;25(2):172-176.

'Complimentary access to full text of this article has been provided by the World Scientific Publishing Co. (Singapore) and requires registration at the journal website. Registration is free.'

This manuscript also provides food for thought. This is from a highly accomplished group in Tokyo. They provide a cohort comparative study between the use of operative pinning and non-operative treatment for Mallet finger injuries. The results suggest the mean extension lag of the DIP joint in the surgical treatment group was significantly better, 2 degrees lag, than it was in the conservative treatment, 13 degrees lag.

What is the International Orthopaedic Diversity Alliance (IODA)?

IODA warmly invites all APFSSH Members and trainees (including hand surgeons of all specialties) to join this newly formed network of collective expertise in diversity and inclusion. IODA is an international collaboration of orthopaedic surgeons in leadership, advocating for the inclusion of women and other groups or individuals who are underrepresented in orthopaedic surgery. Our Board of Directors represents orthopaedic surgeons around the globe and is led by Kristy Weber, AAOS Immediate Past President. IODA is driving discussions at orthopaedic meetings.

IODA Strategic priorities:

Our Activities: In 2022 IODA is hosting symposia at AAOS, EFORT, SICOT, ISAKOS, ICRE (International Conference for Residency Education) in addition to presentations at the Asia Pacific Orthopaedic Association and the national orthopaedic meetings of the Australia/New Zealand, Tunisia and Iraq. Our members are actively promoting diversity in Argentina, Austria, Belgium, Brazil, Canada, Chile, Estonia, India, Italy, Malawi, Malaysia, the Philippines, South Africa, Sweden, Switzerland, the United Kingdom and many other nations. Please see this link to "Connections', the enewsletter of the Asia Pacific Orthopaedic Association (APOA) promoting Diversity and Inclusion.

In addition, we are hosting 3 webinars, e-publishing the IODA quarterly newsletter, contributing to podcasts, developing resources, increasing our network and working towards our strategic goals.

IODA is honoured to be supported by the Presidents of Orthopaedic Associations around the world and welcome more leaders to join. Leadership is the driver of the 4 most successful diversity strategies - Communicating & embedding values, behaviours & cultural norms; ensuring recruitment & promotion processes are unbiased & a diverse set of decision makers; creating work models that support people with family responsibilities; and a visible and committed leadership. (Bain & Co. and Chief Executive Women, 2011).

The IODA website is a “diversity hub” to connect advocates, promote events, support research & provide resources through our extensive diversity library of publications, webinars, and podcasts. Everyone interested in diversity in orthopaedics is welcome & membership is free. Please enjoy our latest newsletter featuring great stories & initiatives. IODA members hope to be able to contribute to the APFSSH 2023 in Singapore theme “Diverse and Inclusive.” Please follow us on LinkedIn, Twitter, Facebook or Instagram or use your mobile phone camera to scan the QR code to go to the IODA website.

International Federation of Societies for Surgery of the Hand (IFSSH)

At the time of writing, the IFSSH President, Marc Garcia-Elias, and Secretary-General, Raja Sabapathy, are in London undertaking the final site visit. The preparations are outstanding. In six weeks, after six years of planning, the congress centre will fill with hand surgeons, hand therapists and industry representatives. The atmosphere will be one of excitement and relief: we are joining together as an international hand surgery community for the first time since Berlin (June, 2019) after the unprecedented changes of these past years.

The international level of involvement in this congress is extensive. Whilst the local organising committee is run by the British Society, an International Advisory Panel has been integral with advice and contributions. The symposia and free paper sessions are balanced with speakers from all continents. The travelling fellowship scheme, introduced for this congress by the BSSH, will bring 33 Hand Surgery fellows from worldwide locations to the UK to experience two weeks at British hand surgery centres prior to the congress. Throughout the registration process, the number of countries represented continues to climb. Already we know that over 80 nations will be represented and this figure is still increasing.

Throughout the congress preparations, the presence, support and enthusiasm of our Asian-Pacific members is clear. At the highest level, we will be honoured to receive Professor Gus McGrouther (Singapore) as the Presidential Lecturer. At the Opening Ceremony we will induct five distinguished members of the Asian-Pacific region as IFSSH Pioneers of Hand Surgery.

The IFSSH Delegates' Council includes 16 delegates who represent Asian-Pacific member societies. Amongst the matters to be discussed within the 2022 Council Meeting is the selection of the host society for the 2028 IFSSH Triennial Congress. This Congress will return to the Asian-Pacific region with bids from the Association of Chinese-Speaking Hand Surgeons United and the Singapore Society for Hand Surgery.

Another decision to be made is the selection of the host society of the inaugural IFSSH Mid-Term Course in Hand Surgery. This will be held in 2023/24 and is to be hosted by either an Asian-Pacific or South American society (as the 2022 Congress is in London and the 2025 Congress in Washington, D.C - therefore all four IFSSH regions are covered). Bids have arrived from the Australian Hand Surgery Society, Bolivian Association of Hand Surgery, Ecuadorian Hand Surgery Society, and Thai Society for Surgery of the Hand, yet again demonstrating the willingness of your region to lead and organise international events.

For the first time in 2022, the IFSSH Executive Committee elections will have specific positions available for regional representation. A review of the bylaws was conducted in 2020 and this included a revision of the composition of the Executive and Nominating Committees. Overall the new structure increases the number of members to allow greater participation, streamlines the succession plan, and introduces five Members-at-Large on a regional basis (two from Europe/Africa to accommodate the large number of societies in this region, one from North/Central America, one from South America, and one from Asia-Pacific). We are excited to have the regions represented in this new IFSSH Executive Committee format.

For the next few weeks, please regularly check the congress website - http://www.ifssh-ifsht2022.com/. It is continually updated with information including the most current congress programme, listings of the congress social events, suggestions for London tourism, and hotel recommendations. Plan your trip and allow plenty of time to reconnect with colleagues from near and far. We are an international federation of hand surgeons and this is our triennial opportunity to be in one place at one time. We look forward to our week in London - one of learning from each other and sharing good company.