Asian Pacific Federation of Societies for Surgery of the Hand

in this issue
Message from President-Elect page 2
Treasurer's Report page 4
Update on Our Journalpage 6
Society in the Spotlightpage 8
JHS-AP Article In-Focuspage 14
Diversity in Hand Surgery page 16
Hand Surgery in Vietnampage 19
News from IFSSHpage 21
Member Society Statuspage 23
Upcoming Eventspage 28
Our Sponsorspage 30

"Ah, but a man’s reach should exceed his grasp,
Or what’s a heaven for?"

—Robert Browning in Andrea del Sarto

Welcome to the fourth issue of ‘Hands-On’, the official newsletter of the Asian-Pacific Federation of Societies for Surgery of the Hand (APFSSH) . We are looking forward to the upcoming biennial meeting at Singapore. The organizers have promised a 'Diverse and Inclusive' meeting with an exhilarating and multi-faceted scientific program. It will be a great opportunity to catch up with friends and colleagues at this long awaited physical meeting after the pandemic.

In this issue, we have Prof Hung from Vietnam talking about Hand Surgery in his country. We look forward to Vietnam joining the APFSSH fraternity in the near future.

Happy Reading and See You Soon.

Editorial Team @ APFSSH Newsletter
Jennifer, Norimasa, Pankaj, Raymar, and Sandeep

Fellowship: 'Friendly association, especially with people who share one's interests.'

"Personal connections are so important both academically, socially and personally" Anthony Berger
PRESIDENT ELECT APFSSH

Those of us fortunate enough to be able to attend the IFSSH meeting in London face- to-face felt a great sense of relief and excitement at the possible return to some form of normality at least in the academic world. Whist the world wide COVID restrictions forced us to continue our academic, professional and social relationships remotely via electronic means I personally never felt fully involved and fulfilled as I was with face to face meetings.Yes, we did have the opportunity to perhaps log in to more meetings that we may not otherwise have been able to attend. Perhaps more guest speakers could be invited to attend virtually than would be otherwise possible due to cost and location. Obviously having speakers waking up at all hours of the night to present virtual talks on the other side of the world is not ideal but at least some form of ongoing education and connection was possible.

A lot has changed since our last face-to-face meeting in Melbourne in March 2020 on the eve of the pandemic but the desire to meet in person was still very strong and being able to catch up with colleagues in person in London 2 years later was a great relief. Personal connections are so important both academically, socially and personally. One can read a scientific paper but nothing can compete with seeing the presenter in person and discussing things in person. It is so much better to question and discuss topics in person, to question more deeply and pick up so many nuances that are just not possible in the virtual world.

A highlight for me at the London IFSSH was attending a small reunion of all our past Victorian Hand Surgery Associates UK hand fellows. We started our Hand Fellowship program in 1996 and have had 43 fellows to date. It was great to be able

to catch up with 11 of those past UK fellows who worked with us as far back as 1999. Meeting in person to see how everyone looked, to talk about the past and about what each of us has done since their fellowship. I recalled my time as a Fellow in Louisville back in the late 80’s with Raja Sabapathy and Fumi Kanaya and many others and again the friendships we formed. Also catching up with other Louisville fellows in London was a great joy. Whilst facts and figures can be learnt on line, journal articles can be read and techniques developed and our knowledge of hand surgery broadened there is nothing like exchanging ideas face-to-face to really learn about surgery. All of us who have completed Fellowship training in Hand Surgery will know and understand the value not only in face-to-face teaching within an apprenticeship like environment but also the great value in developing friendships with colleagues from other countries. As was evidenced by the number of Fellows at our reunion in London, those friendships can often remain for a lifetime. Again, the personal interaction and relationship is so valuable and I feel the necessary global restrictions forced upon us during the pandemic have simply reinforced this need.

**Victorian Hand Surgery UK Fellows Reunion aboard the 'The Golden Hind'**
(L to R): Ian Grant, Alistair Graeme, Henk Giele, Chrish Mariathas, Tim Halsey, Chris Powell, Charles Bain, Philippa Rust, Dave McCombe, Anthony Berger, Jonathan Jones, Rob Poulter, Anmar Alshawi, Ian McNab

Shortly the APFSSH Education Committee will be announcing the launching of the APFSSH Travelling Fellowship Program. This Fellowship is aimed at providing financial and admin. assistance for a young surgeon from a member society to travel to a hand surgery meeting and visit Hand Surgery centres in other parts of the world to gain experience, knowledge and to develop long term friendships that will hopefully last a lifetime. Again, the value in face-to-face meetings and in the exchanging and discussion of ideas is unmeasurable. Please keep an eye out for further announcements and information on the application processes. I hope to see you in Singapore next May for what I am sure will be a wonderful APFSSH meeting.

Anthony Berger, President Elect, APFSSH
tony.berger@vhsa.com.au

A New Chapter

"Grow and evolve the role of the treasurer in more proactive management of our available funds." Alphonsus Chong
TREASURER, APFSSH

I am happy to let everyone know our society's financial activities have really taken off. The ability to do digital banking has been a godsend in this Covid pandemic times. Beyond the receipt of subscriptions and donations, we have been able to properly manage financial transactions such as payment for services. In fact this newsletter is partly made possible because we can now charge for advertising! Please don't skip them when you read the newsletter, as sponsors who advertise play an important role in making sure our society can fulfil its mission.

As I approach the end of my term as Treasurer, Bened, our secretariat staff, and I are working hard to put into place processes and enablers to support this aspect of the society work. In particular, future Treasurers may not be from Singapore and would not be as familiar with our banking, accounting and financial reporting systems and practices. For example, Bened will be taking over from me some financial administrative functions to better the support the society, such as preparing the financial statements and tax returns.

Now that the fundamental aspects of APFSSH's financial management has been settled, the focus can shift to other areas. One possible next step as we grow and evolve the role of the treasurer is more proactive management of our available funds. For example, we can look at making our current funds work harder for us. The recent wave of inflationary pressures and rise in interests rates is being felt everyone. A silver lining to this is that local fixed deposit interest rates are becoming very attractive once again. To do this will need deliberation by our

exco and approval of the membership of APFSSH.

As the risks from Covid recedes and physical travel once again becomes more widespread, I look forward to more physical meetings with our colleagues within the region. In particular, on behalf of Singapore, I welcome everyone to our beautiful country from 31 May to 2 June for an exciting APFSSH scientific meeting!

Alphonsus Chong, Treasurer, APFSSH
alfchong@gmail.com

Reflections at One Year

"We invite all surgeons in the region to visit the journal web page, register and avail access to the full text of the case reports and selected articles." Raja Sabapathy
EDITOR-IN-CHIEF, JHS-AP

It is one year since the present editorial team took the reins of the journal and it is a good time to reflect. A year back writing in the December 2021 issue of the newsletter, I was penning the goal of the editorial board thus, ‘JHS – AP should be regarded not as the toughest journal for an author to get his work published, but as a journal that Hand Surgeons would love to read and one that would help them get better outcomes with their patients’. Are we closer to that goal ? I think so and it will ever remain a work in progress.

Significant achievements have been our move to the Editorial Manager platform. This took a lot of effort but has helped in streamlining the submission and editorial process. We also completed the processing of all the articles submitted at the previous web site. We have been able to increase our reach and readership interest. The year saw the increase in the number of issues from four to six, enabling us quicker publication of the accepted articles. With each issue containing about 15 to 20 original articles and 10 case reports we have a right mix up of articles for the journal. Further with the help of our publishers, the World Scientific we were able to provide free access to the case reports and selected articles. This increased the hits and the downloads. The publishers state that in 2021, the researchers viewed the abstracts and downloaded the articles in JHS -AP, 6621 times. In 2022, it increased to 156,401 times, indicating a massive rise in interest. That is encouraging. We invite all surgeons in the region to visit the journal web page, register and avail access to the full text of the case reports and selected articles. The publishers have been kind to provide free full text access to two original articles every 6 months to coincide with the publication of every newsletter. A list of these articles that have been

made available in previous issues of the newsletter include:

As we move on, we intend to process the submissions faster and good reviewers are essential for this. As you read this newsletter, if you have the inclination to review or know of someone who has the talent and interest, please do let us know. Active editorial board members and skilled reviewers are the key to the success of the journal.

As the Editor-in-Chief, I am fortunate to work with a team of good editors and I particularly thank Sandeep Sebastin and Praveen Bhardwaj for their help. The CEO of a largely successful multinational company was once asked as to when they start looking for the successor. He replied that he started it on the day he took over. On the same token, I started doing that just when I took over and feel that with the talent pool available in the team and the region, our journal will continue to flourish.

We all can attend in person, the next APFSSH congress in Singapore (May 31st to June 3rd, 2023. The editors would like to meet with the delegates to have your feedback and suggestions to make our journal the premier journal of the specialty in the world.

Raja Sabapathy, Editor-in-Chief, JHS-AP
rajahand@gmail.com

The History of the Thai Society for Surgery of the Hand

Hand Surgeries in Thailand were previously performed by general surgeons. In the aftermath of World War II, many Thai surgeons came back after finishing training abroad

1888: Beginning of modern medicine in Thailand at Siriraj Hospital
1950: Fuang Satayasanguan, the 1st Thai Orthopaedic surgeon trained in USA before WW II, along with Lim Koonvisal, a Plastic Surgeon, started Hand Surgery service.
1959: Vasant ChongChet, after his graduation from England, treated many factory-related hand injury patients at Vajira hospital.
1964: Thamrongrat Kaewkarn, the 1st Asian who received a Diploma of American Board of Orthopaedic Surgery, had experience working with several renowned Hand Surgeons in USA.

The period after this could be recognized as the establishment of Hand Surgery unit and training. From 1965 to 1975, there were many Orthopaedic and Plastic Surgeons who trained in Hand Surgery overseas and began Hand Surgery service in their own hospitals, including training, as follows:

1971: Vivat Visuthikosol, a Plastic Surgeon, established the 1st hand surgery training center of Thailand in Ramathibodi hospital, with Arthi Kruwit as his 1st resident. Surasak Muangsombat established the Hand and Microsurgery division at the Department of Surgery, Siriraj hospital.
1972: Charoen Chotigavanich received the Diploma of American Board of Orthopaedic Surgery and trained under many renowned Hand Surgeons in the USA.
1973: Pongsak Vatana completed his Diploma of American Board of Orthopaedic Surgery and Hand surgery and came back to start Orthopaedic and Hand Surgery work at the department of Orthopaedics, Lerdsin Hospital.

Meanwhile, Thailand was still an endemic area for leprosy. There were a number of patients with hand deformities following leprosy that needed surgical correction.

Amongst the hospitals with Hand Surgery service, Prapadang Hospital was an outstanding hospital in service of this special group of patients with the efforts of Ake Thadthong and Chamlong Mungkarndi. They worked in collaboration with Prof. PW Brand, who was one of the great Hand Surgeons in leprosy. A few Hand Surgeons also had a good memory and experience of working in this leprosy hospital, for instance, Sommart Kaewrochana, Arthi Kruwit in early years, and Chairoj Uerpairojkit many years later.

The Thai Society for Surgery of the Hand was officially established in 1977, at Pramongkutklao Hospital and the first committee members included:

Logo of the Thai Society for Surgery of the Hand

Chamlong Mungkarndi (Priest hospital)
Prateep Bhokakul (Lerdsin hospital)
Pongsak Vatana (Lerdsin hospital)
Charoen Chotigavanich (Siriraj hospital)
Vivat Visutikosol (Ramathibodi hospital)
Surasak Muangsombut (Siriraj hospital)
Vasant Chongchet (Vajira hospital)
Nakorn Suvanprakorn (Klang hospital)
Dumronk Thanachanant (Pramongkutklao hospital)

**The First Committee of the Thai Society for Surgery of the Hand**

The objectives of the Thai Society for Surgery of the Hand are exchanging experiences, sharing, and strengthening knowledge of Hand Surgery as well as training and extending the knowledge to residents and surgeons who take responsibility in Hand Surgery. The next period is the period of development of microsurgery, which started from 1975 to 2000 in which replantation surgery and all reconstructive surgery using microscope such as free flap, as well as brachial plexus surgery took predominance.

Since 2000, the trend in Hand Surgery has changed to minimally invasive but more sophisticated procedures like arthroscopy. Furthermore, the Hand surgery field had also gradually extended proximally to include the elbow and shoulder regions which had expanded the knowledge of Hand Surgery exponentially. Thai Hand Surgeons also trained overseas to gain knowledge in the particular fields as listed below:

**The 6th APFSSH held in Bangkok, 2006**

In Thailand, we also have training centers for Hand Surgery. In general, after finishing Orthopaedic residency training, they may opt to gain some experiences in the provincial hospital for 1 or 2 years before choosing to apply for fellowship training in specialty area. Hand surgery is one of the popular specialties chosen by graduating residents. The first Hand Surgery fellowship program started in 1994 at Siriraj Hospital. In 1996, King Chulalongkorn Memorial hospital began the 2nd Hand Surgery fellowship program. Then, in 2003, Lerdsin hospital started the 3rd Hand Surgery fellowship training. After that, many centers have opened the Hand Surgery fellowship training programs.

Lastly, the Thai Society for Surgery of the Hand also had the honour to host international meeting for many hand conferences:

**The 1st Brachial plexus Cadaveric course at Chulalongkorn University in 2012**

**Combined Thailand-Malaysia-Singapore Hand Meeting and Flap Dissection Cadaveric Course, Chiangmai, 2019**

Chairoj Uerpairojkit, President, Thai Society for Surgery of the Hand
chairoj-hand@hotmail.com

Ten Questions About Wide Awake Local Anesthesia No Tourniquet Surgery Lalonde DH. J Hand Surg Asian Pac Vol. 2022 Apr;27(2):219-225.
'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.'

Many new concepts and technologies have been introduced in the Hand Surgery in the past 20 years. These include a variety of locking plate systems, collagenase, minimally-invasive endoscopic and arthroscopic surgeries, and tissue engineering for tissue defects, etc. Another great innovation in our practice is the wide-awake local anesthesia with no tourniquet (WALANT) technique. This was first described by Dr. Donald H. Lalonde over a decade ago. WALANT has become popular for various Hand procedures, has improved the outcomes in many conditions, and has substantially contributed to health-care savings. Especially during a pandemic like the COVID with limited healthcare resources affects elective surgeries. It is important to minimize unnecessary exposure between healthcare providers and patients, WALANT can be an opportunity to provide continued care to patients.

**Basic Tray for all WALANT Procedures**

In this review article, the author and pioneer of the WALANT provides many important tips and tricks that can help surgeons to start this valuable and rewarding procedure. The author addressed this in the form of a series of 10 questions including the latest advances and updates. I hope many readers of our journal, who may not have started this technique yet, can join the WALANT-practicing group. This will allow them to enjoy the pleasure of watching the immediate, dynamic result of surgery and the useful time during the surgery to know and teach patients.

Hyun Sik Gong, Editor, JHS-AP
hsgong@snu.ac.kr

A Pragmatic and Evidence-Based Approach to Mallet Finger. Nashi N, Sebastin SJ. J Hand Surg Asian Pac Vol. 2021 Sep;26(3):319-332.
'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.'

Mallet finger is a common injury affecting the terminal extensor mechanism at the distal interphalangeal joint. The management is mostly conservative, but surgery is necessary in some patients. Although we see a lot of this injury, there is little consensus on the indications for surgery or the best surgical option.

In this review, the authors provide a pragmatic and evidence-based approach to mallet finger that will guide the treating surgeon in providing best care for their patient. They present an in-depth, comprehensive, and latest review on this injury, including historical perspective, epidemiology, anatomy and pathomechanics, as well as clinical assessment and treatment based on their expertise and extensive experience.

In particular, the authors’ surgical tips and detailed radiographic demonstration of the procedures regarding the extension block pinning and the hook plate fixation are excellent and a pleasure to read. Although most of our readers are familiar with surgical techniques for mallet finger, they will find something to learn from this review and can refresh their knowledge.

**Fluoroscopic images showing authors preferred method of extension block pinning**

Hyun Sik Gong, Editor, JHS-AP
hsgong@snu.ac.kr

Asia-Pacific is one of the most diverse regions in the world, involving many nations and ethnic groups. APFSSH includes 13 federation members, with each having its own cultural background. Consequently, they all have different approaches in handling gender diversity, a growing concern in the current medical field

**Orthopaedic Women of AOA & NZOA at the Combined NZOA/AOA Annual Scientific Meeting in Christchurch NZ - November 2022,** including Annette Holian (President AOA), Margaret Fok (Invited APOA Professor), Juliette Gentle (Chair AOA Orthopaedic Women’s Link), Georgina Chan & Nikki Hooper (Chairs LIONZ – Ladies in Orthopaedics NZ), Rujuta Mehta (President W.O.I.C.E. – Women of Orthopaedics India Collective Empowerment) and Jennifer Green (President International Orthopaedic Diversity Alliance.)

Despite the gender ratio in most of the medical school is around 50:50, there remains a discrepancy in the gender radio among hand surgeons, with significantly more male than female hand surgeons. Hand surgeons can be trained under Orthopaedic (e.g., Hong Kong, South Korea), plastic (e.g., Taiwan) or even as an individual specialty (e.g., Singapore) in different nations. This in turn may affect the number of female surgeons admitted to the field. It is well known that the percentage of female Orthopaedic surgeons around the world are much less than male in general.

In Asia-Pacific, some countries have set up dedicated societies to advocate and encourage female to join Orthopaedic / Hand Surgeries e.g., Orthopaedic Woman’s Link (OWL) in Australia, Woman in Orthopaedics (WIO) in India and Ladies in Orthopaedics New Zealand (LIONZ) in New Zealand. This creates a support network to

mentor and advise junior trainees or medical students. In some cases, they may even have reserved seats for female and other minorities in their executive board e.g., New Zealand Orthopaedic Association, in order to bring in a more balanced environment. By contrast there are countries which may prefer status quo and just let the traditional system lead its way.

Hand surgeons in Hong Kong are all orthopaedically trained surgeons. The gender ratio for orthopaedic specialists is 92 male : 8 female. Discussion in gender diversity is minimal and there is no chapter or dedicated societies in promoting diversity or in helping minorities to advocate their issues and concerns. Yet, interestingly our executive committee of Hong Kong Society for Surgery of the Hand (HKSSH) has one of the best gender ratios among the APFSSH federations, being 50:50. Our committee comprises of a group of Hand Surgeons from different hospital clusters of Hong Kong. We do not have any prerequisite on the gender ratio nor have designated seat for female surgeons in the committee. By chance, a significant percentage of our senior female Orthopaedic specialists are Hand Surgeons. As such this attracts young female trainees who are seeking for role models and ally to join the subspecialty.

**Executive Council (2022-2024): Hong Kong Society for Surgery of the Hand**

The popularity of doing Hand Surgery among female colleagues is not without its problem. It has been noted that many female Orthopaedic trainees are being stereotyped that they would choose the career path of hand surgery. In turn, they do get the opportunity to look into other subspecialties e.g., spine, and joint. In addition, there remain surgeons who do not admit that there is gender disparity in Orthopaedics and attempt to ignore issues arise. It is through continuous education and advertisement to bring awareness on gender diversity to all the parties involved which we can make a change. We need to educate our younger generation about inclusion and diversity and hope to attain an equilibrium in the future.

Gender diversity is actually not just about male and female. There are other entities like gay, lesbian, transgender etc. These issues may be even more difficult to tackle in some Asia-Pacific nations, due to their specific cultural backgrounds. Yet it has been shown that a well diverse gender society work better in harmony and in turn attain better results. We strive to attain a society which will give everyone an equal opportunity and in turn be judged by merit but not gender.

Margaret Fok, Hand Surgeon, Hong Kong
margaret_fok@yahoo.com

Vietnam had the first Covid infected cases at the end of the year 2019 and became one of the most seriously impacted countries in South East Asian region. During the two years 2020-2021 the country has suffered 4 outbreaks which badly affected all

**Hand Surgeons getting ready to go to a 'hot-spot' to collect viral specimens**

aspects of life. The Vietnamese Hand Surgeons had to participate in many tasks against the widespread of the Covid pandemic. However, they tried their best to perform their professional works besides the unprecedented duties.

Hand replantation

Replantation on children is always challenging. A 12-month-old child was admitted with her severed right hand 5 hours after a traffic accident. The hand was successfully replanted.

**Trans-metacarpal right hand amputation**

**Appearance 10 days post replantation**

Technical transfer

Helping colleagues in other specialities to improve their microsurgical skill has gradually become a routine duty for Hand Surgeons. In 2021, two 'technical skill transfer tours' were launched with four Hand Surgeons. Young orthopaedic surgeons had opportunity to discuss some complex cases and then do microsurgical reconstruction under supervision.

Meetings

15 reports were presented at the 2021 annual meeting of Hand Surgeons. This included cases of trauma, peripheral nerve injury, reconstruction, plastic surgery, and congenital deformities. The meeting attracted more than 70 surgeons on site and 100 on line. In the 2022 annual meeting of Orthopaedic Network, 5 presentations of Hand Surgery were selected for presentation during the main session. This was the first Orthopaedic meeting on-site after the nation wide lock down was lifted. More than 250 surgeons attended it.

Microsurgical Training

A one day microsurgical training course was conducted at the University of Medicine and Pharmacy Microsurgery Training Laboratory along with the support of faculty from the National University Hospital, Singapore in November 2022.

A/ Prof Do Phuoc Hung, Chair, Orthopaedic Surgery
University of Medicine & Pharmacy, Ho Chi Minh City, Vietnam
dphungcr@yahoo.com

International Federation of Societies for Surgery of the Hand

The 2028 17th IFSSH Congress in Singapore entitled “Toward sustainable Hand Surgery and Therapy” will be very relevant. All Hand Surgeons across the world enjoy meetings and congresses. The loss of freedom in the pandemic made us realise how important it is to meet colleagues and friends, to teach, to exchange ideas and to learn from others. Yet at the same time we learnt that we can still meet and learn and exchange ideas with Zoom and Teams. Indeed, learning opportunities probably increased; it has become easier to arrange meetings with more speakers yet without the expense of travel or the need to take busy delegates and busy lecturers away from their practice, with the jet lag and expense and carbon emission that would entail. As the next few years pass there will be a tension between the huge personal pleasure and professional advantage of face-to-face meetings set against the concerns of emission-derived climate change. Travel with carbon offset and rapid advances in low-emission transport will certainly help keep our cherished meetings alive; hybrid meetings also have a role to play as this expands our reach to those far away with little financial resource who will benefit from education but cannot afford the cost of travel.

The IFSSH is committed to expanding our help across the world. We now have 5 new members-at-large who liaise with the delegates in their region to bring information, requests and local knowledge into the work of IFSSH. We provide education more diversely than previously (when we just had a Congress every three years). This new endeavour starts with the first mid-term instructional course in Ecuador in January 2024 which will have a strong South American influence.Other regions will have a similar opportunity in future years.

The IFSSH is ideally placed to support global collaboration in hand surgery. Some IFSSH Member Societies across the world already support well established outreach programmes for low- and middle-income countries providing surgical teams, educational resources and even certification. Other Member Societies may need to receive this help. There are other countries who do not have their own hand societies and so are not part of IFSSH who need the most help. Our IFSSH delegates and members-at- large, will help us understand who needs what and who provides what. Co-ordination between some organisations is already underway to avoid duplication and create synergy in global provision. A simple repository on our website can link key individuals in different societies and provide access to learning material and programmes at no cost to all those who need it.

**IFSSH Ex-Co Meeting - 2022**
(L-R): Jin Bo Tang, Belinda Smith, David Warwick, Raja Sabapathy, Gregory Bain, Daniel Nagle, Marc Garcia Elias, David Shewring, Francisco del Piñal, Aida Garcia Gomez, and Jorge Clifton Correa

Education costs money; IFSSH relies on its membership fees, growth in our investments (which is very uncertain in these times of political and financial turmoil) and money from its Congress. We seek further sources so that our budget can meet our ambitions and potential- a generous legacy, personal donation or corporate assistance would make a huge difference.

David Warwick, Secretary General, IFSSH
davidwarwick@handsurgery.co.uk

Hong Kong Society for Surgery of the Hand (HKSSH)

This year, COVID-19 has continued to affect our region and our society has been able to continue promoting Hand Surgery by several on-line webinars.

Beijing-Hong Kong Hand Meeting
It was the 4th Beijing-Hong Kong Hand Meeting since 2017. In the light of the COVID pandemic, the meeting for this year has been changed to an online meeting. Six hand experts from Beijing joined the meeting as speakers. Together with 6 speakers from HKSSH, a fruitful program was conducted on the morning of 22nd, January, 2022. There were total 9000 participants who joined the meeting and it was a successful one.

34th HKSSH Annual Congress
Our 34th Annual Congress was held successfully on 19th and 20th March, 2022 with AAHS as our guest society. Due to COVID pandemic, the annual congress was held online. There were 10 hand experts from the US joined the meeting as speakers: Julie Adams, Kyle Eberlin, Glen Gaston, Jason Ko, John Lubahn, Amy Moore, Peter Murray, Nash Naam, Mark Rekant, Dan Zlowtolow together with our local speakers, we had productive discussion about various nerve conditions of the upper limbs.

DGH Congress 2022
HKSSH was invited as the guest society for the German Hand congress 2022 being held on 6th to 8th October, 2022. The meeting took place in Garmisch-Partenkirchen, Germany. The theme of the meeting was “Children’s hand, thumb and radial side wrist, mini-invasive procedures”. In addition, Dr. PC Ho was invited as the speaker for the “Buck-Gramcko Lecture”.We had a rewarding meeting and had extended our friendship with fellow hand surgeons in Germany.

**(L-R):** Dr. PC Ho, Dr. Margaret Fok, Dr. Esther Chow, Dr. Hildegunde Piza, Dr. Wiebke Huelsemann, Dr. Martin Langer, Dr. Eva-Maria Baur, Dr. Emily Yip, Dr. Jeffrey Koo

**(L-R):** Dr. PC Ho, Dr. Nicola Borisch, Dr. Esther Chow, Dr. Jeffrey Koo, Dr. Emily Yip

HKOA Annual Congress
The HKOA annual congress was held on 5th – 6th November, 2022. The theme of the congress was “ Off the Beaten Track. The unusual, the unexpected, the unmissable”. This year, HKSSH hosted a free paper session, a concurrent session and 2 plenary lectures around the theme “congenital hand anomalies”.We had invited several overseas speakers. Dr. Wee Leon Lam (UK) gave a talk on “Congenital Hand Surgery: how my practice has changed”. Dr. Shanlin Chen (China) gave a talk on “PRUJ Synostosis” and Prof. Goo Hyun Baek (Korea) gave a talk on “Clinodactyly and Camptodactyly”.

**(L-R):** Dr.Michelle Li, Dr. WL Tse, Dr. SC Koo, Dr. Wee Lam, Dr. PC Ho, Dr. Esther Chow, Dr. Florence Pang, Dr. PT Chan

Esther Chow, President-Elect, HKSSH
esther_cs_chow@hotmail.com

Executive Body HKSSH
President:	Dr KOO Siu Cheong Jeffrey Justin
Vice-President:	Dr YAU Leung Kai Edmund
President-Elect:	Dr CHOW Esther Ching San
Honorary Secretary:	Dr YIP Ka Yan Emily
Honorary Treasurer:	Dr. FOK Woon Man Margaret
Members:	Dr LEE Syn Yuk Michelle, Dr TAM Ka Ki, Dr TSE Wing Lim

Indonesian Orthopaedic Association For Upper Limb & Reconstructive Microsurgery Perhimpunan Bedah Ekstremitas Atas dan Mikro Rekonstruksi Indonesia (PERAMOI)

The annual meeting of PERAMOI was held in Banyuwangi, East Java from 28th to 29th October 2022 with the theme of “Helping Hands for a Better Care in Upper Limb Service Throughout Indonesia”. It was catered to both orthopaedic specialists and general practitioners, and consisting of lectures, interactive workshop and a charity event

Recently, we noticed an increase in musculoskeletal problems suffered by various levels of society in Indonesia but a lack of orthopaedic-based treatment to meet the needs of various communities. This year we decided to focus on scientific developments, new surgical techniques and innovations in common upper limb injuries, highlighting those performed by our current members throughout this past year. We are pleased to inform that we had a total of 138 participants this year, despite the existing Covid restrictions. Free papers and poster presentations were also held, providing current information about the latest research as well as cases in the communities. We hope that our attendees enjoyed the events and most importantly are able to use their newfound knowledge to improve upper extremities management in their own communities.

The charity event was held at Tresna Werdha Social and Technical Service Unit where we had the opportunity to support senior members of the community with their daily needs. We sincerely wish that they could stay healthy and live happily. In conjunction with the scientific events, we also held a one-day tour to explore the city of Banyuwangi. enjoying the exotic International Cultural Gandrung Sewu Festival that featured thousands of Gandrung dancers performing out on the beach. At the end of the tour, we climbed the Ijen crater (‘Kawah Ijen’), a plateau at the top of Ijen volcano known for its phenomenal blue fire, acidic crater lake and labour-intensive sulphur mining. Its beauty has been recognized across the world and has been included in UNESCO’s World Biosphere Reserves.

We invite and welcome all APFSSH members to our future meetings and I look forward to meeting all of you in person soon. Stay healthy and stay safe!

Made Bramantya Karna, President, PERAMOI
peramoi.org@gmail.com

Executive Body PERAMOI
President:	Made Bramantya Karna
Vice-President:	Widya Arsa
Hon. Secretary:	Thomas Erwin Christian Junus Huwae
Treasurer:	Tito Sumarwoto
Treasurer:	Pramono Ari Wibowo

OFFICE BEARERS
President:	Raja Sabapathy	rajahand@gmail.com
President-Elect:	Anthony Berger	tony.berger@vhsa.com.au
Secretary General:	Fuminori Kanaya	fkanaya@med.u-ryukyu.ac.jp
Treasurer:	Alphonsus Chong	alfchong@gmail.com
Imm. Past President:	Goo Hyun Baek	ghbaek@snu.ac.krer
Members-at-Large:	Clara Wong	clara.wongclara@gmail.com
	Michael Boland	michael@handsurgeon.co.nz
	Norimasa Iwasaki	niwasaki@med.hokudai.ac.jp
	Jeremy Prakash	jeremyp7@gmail.com
	Sandeep Sebastin	sandeepsebastin@gmail.com

NEWSLETTER EDITORIAL TEAM
Jennifer Green	Australia	jennifer.green1312@gmail.com
Norimasa Iwasaki	Japan	niwasaki@med.hokudai.ac.jp
Pankaj Ahire	Pankaj Ahire	drahire@hotmail.com
Raymar Sibonga	Philippines	Philippines
Sandeep Sebastin	Singapore	sandeepsebastin@gmail.com

APFSSH SECRETARIAT
Ms Bened Thong Department of Hand & Reconstructive Microsurgery National University Hospital, NUHS Tower Block Level 11, 1E Kent Ridge Road Singapore 119228 Tel: +65 6772 5549 Fax: +65 6772 2358 E-mail: admin@apfssh.net