College of Surgeons, Singapore

Overview of Hand Surgery in Singapore

5Nerve Compression Syndromes - authored by A/Prof Lim Beng Hai

The hand is a compact biological organ with very important and intricate mechanical functions. For almost a century, surgeons have realised the complexity of this organ and have made great effort in developing specialised care of the hand. In the past, surgery to heal a diseased or injured hand often failed to restore its function. However, in the last 35 years, there has been an accelerated development in hand surgery with better understanding of the anatomy and the introduction of new microsurgical techniques. Surgery of the. hand today demands an extensive knowledge of the anatomy, a wide surgical armamentarium, refined complex microsurgical techniques and a rational rehabilitation plan. Interested surgeons from general, plastic or orthopaedic surgery have concentrated their practice mainly in hand surgery. To enhance the training and practice of hand surgery, countries such as Sweden, Finland, Norway, China and Singapore have developed or are in the process of developing hand surgery as an independent specialty.' The United States of America, Venezuela, Argentina, Brazil, member states of the European Community and the Republic of South Africa have introduced training programmes and examinations leading to the certificate of added qualification,2 degree or certification in hand surgery.

The interest in hand surgery in Singapore started way back in 1961 with the introduction of a tendon transfer programme in a leprosarium by K H Yeoh. The surgical management and care of the injured hand were improved by various heads of orthopaedic departments who set up special hand clinics to manage these difficult cases. The 1960s saw a surge in industrial activities and a corresponding increase in the incidence of hand injuries. The plastic and reconstructive surgeons then were also involved in the management of these cases by providing the more advanced techniques of resurfacing. Microsurgery was introduced to the country by R W H Pho in 1974. Pho and his team performed the first successful thumb replantation using the microvascular technique in January 1977. The first successful macro replantation of a complete forearm amputation was performed by H S Leong and colleagues in April 1975 and the first successful toe to hand transfer was by S K Tan in 1980.

The Singapore Society for Hand Surgery was formed in 1982 and became a member society of the International Federation of Societies for Surgery of the Hand (IFSSH) in 1986. The interest in hand surgery continued to be sustained and its development accelerated.

The development culminated in the establishment of the Hand Surgery Unit at the Singapore General Hospital on 1 Jan 1985. The Unit subsequently developed into a full department and matured into a national tertiary referral centre for complex hand injuries and conditions. Another department, the Hand and Reconstructive Microsurgery Department, was established at the National University Hospital on 1 December 1990 to complement the hand service at the Singapore General Hospital.

Published with permission from: Teoh LC. Training and Certification of Hand Surgery as an Independent Specialty. Ann Acad Med Singapore 1995; 24 (4 Suppl): 1-2.

Message from the Chapter Chairman, Dr Vincent Tay

The Chapter of Hand Surgeons will be embarking on a 3 year plan of upgrading the education and training of basic and advanced surgical training. This will be in the form of a publications program, improved surgical training programme and revised lecture series. The Chapter looks forward to the support of all the hand surgery units in Singapore towards achieving this objective.