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 30th April and 1st 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. READ MORE
Hand surgery in the Philippines began with two premier orthopedic institutions: The National Orthopedic Hospital (now the Philippine Orthopedic Center) and the University of the Philippines - Philippine General Hospital, Department of Orthopedics. The National Orthopedic Hospital evolved during the aftermath of World War II in 1945 as an Emergency Hospital - The Civilian Aid Unit I, organized by a Filipino Surgeon-Colonel under the USAFFE Medical Corps. READ MORE
The Asia Pacific Federation for Societies for Hand Therapy (APFSHT) was first organized in 2004 at the 1st symposium for Asian hand therapists held in Osaka, Japan. Missions of the APFSHT are to enhance and support international cooperation in clinical hand therapy and education, promote communication and knowledge exchanges between hand therapists and hand surgeons and improve the quantity and quality of education and research in the field of hand therapy within the Asia-Pacific region. READ MORE
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 30th April and 1st 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 a Delegates’ 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-Chuan Teoh (Singapore). LamChuan Teoh, 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 Councill meeting to be held in Singapore on the 19th and 20th 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:
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 AsiaPacific 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 4th Council Meeting in Chennai.
The first APFSSH Congress was conducted in Perth, Australia, in March 1997 with Mark Allison and Tonkin as convenors, Bruce Conolly as the President of the Australian Hand Surgery Society and Tajima as the inaugural APFSSH President. Subsequent congresses have been conducted in Singapore, Chennai, Seoul, Osaka, Bangkok, Hong Kong, Kaoshiung, Bali, and Kuala Lumpur, with the next congress to be hosted by the Philippines Society in Manila in 2017.
The Tajima Lecture was established in 2004 to recognise the contribution to hand surgery of the inaugural APFSSH President.The current APFSSH President has the responsibility of nominating the Tajima Lecturer for each Congress. Those who have been honoured by this invitation are SP Chow (Osaka, 2004), Tonkin (Bangkok, 2006), Yu-Dong Gu (Hong Kong, 2008), Yoshikazu Ikuta (Kaoshiung, 2009), Lam-Chuan Teoh (Bali, 2012) and Kazuteru Doi (Kuala Lumpur, 2014).
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. 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). Goo Hyun Baek from Korea has taken over this role in 2015. Tonkin (Australia) and Moroe Beppu (Japan) have assisted the editorial office as co-Editors. Three issues of the journal are now published yearly, with the intention of moving to four. 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 and now 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.
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.
Hand surgery in the Philippines began with two premier orthopedic institutions: The National Orthopedic Hospital (now the Philippine Orthopedic Center) and the University of the Philippines - Philippine General Hospital (PGH), Department of Orthopedics. The National Orthopedic Hospital evolved during the aftermath of World War II in 1945 as an Emergency Hospital - The Civilian Aid Unit I, organized by a Filipino Surgeon-Colonel under the USAFFE Medical Corps. After the post-war emergency period, the emergency hospital was renamed in 1947 as the “National Orthopedic Hospital” under the Bureau of Health with Dr. JV delos Santos as the first Chief of Hospital. In 1956, the Hand and Peripheral Nerve Surgery Unit was established at the National Orthopedic Hospital with Dr. Buenaventura Canto as head and Dr. Eugenio Inocentes 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, Dr. Inocentes headed the Hand and Peripheral Surgery Unit and had been a lecturer in Hand Surgery until 1999.
At present, the Philippine Orthopedic Center has four consultant hand surgeons working in the Section of Hand Surgery. The Philippine Orthopedic Center is presently the largest center dedicated to orthopedics and is accredited by the Philippine Board of Orthopedics as an orthopedic training institution.
The University of the Philippines College of Medicine -PGH was established in 1908. In 1952, the Section of Orthopedics under Dr. Ambrosio Tangco was established under the Department of Surgery. A promising surgeon Dr. Jose V. Silao, Jr. was sent by Dr. Tangco forhand surgery training in the USA under Dr. R Carrol and under Dr. W Green from 1970-71. In June 1971, the Section of Orthopedics became a separate Department, with Dr. Silao as first Department Chairman. He saw the need for advanced training in the different areas of orthopedics. Graduates of the department were sent overseas for advanced training in adult, trauma, spine, pediatric, and hand orthopedics.
In the late 1970’s up to the early 1980’s, the different sections of orthopedics were formed. This included the Section of Hand Surgery. In 2002, the Section of Hand Surgery established the Microsurgery Service and in 2005, it was renamed the Microsurgery Unit - a multidisciplinary unit dedicated to microsurgical reconstruction needs of patients
Training in hand surgery in the Philippines is part of the comprehensive residency-training program in Orthopedic surgery, certified by the Philippine Board of Orthopedics (PBO). All accredited orthopedic training institutions are required to have their resident or trainee accomplish at least 3 months of clinical training in hand surgery. Orthopedics residency training programs in the Philippines follow a general curriculum issued by the PBO that involves clinical rotations in orthopedic trauma, adult reconstruction, spine, pediatrics, and hand surgery in one accredited hospital during a four-year period. Specific learning objectives, length and order of rotation are individualized by each training institution/hospital. At the end of residency training, surgeons are expected to be proficient in managing common hand conditions. Certification of each training program is granted based on the number of Orthopedic cases seen by each institution and the available facilities for managing Orthopedic patients – number of dedicated beds, clinic hours, operating theater equipment, presence of support services such as rehabilitation, prosthetics/orthotics and pathology services. Presently, the Section of Hand and Microsurgery of the PGH has six consultant faculty members supervising resident training and management of service cases. In the Section of Hand Surgery of the Department of Orthopedics, PGH is the only institution in the country that offers a clinical fellowship program in hand surgery since 1995.
This one-year fellowship program is recognized by the Association of Hand Surgeons of the Philippines (AHSP) and the umbrella organization in orthopedics-the Philippine Orthopedic Association. Fellows are exposed to the management of all hand patients for the year and are responsible for taking care of hand patients of the section. All fellows are required to do basic microvascular anastomosis in a rat model as part of their training. They are also required to complete at least one research paper prior to graduation. Aside from managing hand trauma, fellows are also exposed to a variety of microsurgical procedures such as replantation surgery, free tissue flaps for soft tissue coverage, vascularized long bone reconstruction for post traumatic injuries and post-oncologic resections, vascularized joint reconstruction for avascular necrosis of the femoral head and the microsurgical management of obstetric and traumatic brachial plexus injuries. Fellows are also encouraged to take advantage of using the animal laboratory of the Microsurgery Unit to do nerve and vascular repairs in animal models. At present, the fellowship program has graduated five hand specialists. There are no local certifying bodies for Hand Fellowship training in the Philippines as of this writing. Hand surgery in the Philippines is mainly done by orthopedic surgeons with a minority being done by general and plastic surgeons with additional training in hand surgery.
The Philippine Society for Surgery of the Hand was conceptualized to address the needs of the Filipino people for specialized care of the hand. The group was initially formed in 1984 through the initiatives two prominent hand surgeons: Dr. Vicente Pido and Dr. Eugenio Innocentes, Jr. The society had seven founding members with Dr. Pido as president and Dr. Innocentes, as Vice-President. A year later, the society constitution and by-laws were drafted and approved by its members.
The society was later renamed to Association of Hand Surgeons of the Philippines (AHSP) in 2012. Today, the society has expanded its membership to 28 hand surgeons from Orthopedic, General and Plastic Surgery. Since then, the society has conducted various workshops and lectures around the country. Hand surgeons from around the world have helped the society achieve this. Among them were Dr. Tan Ser Kiat (Singapore), Dr. Bruce Conolly
(Australia), Dr. John Wyrick (USA), Dr. Yoshikazu Ikuta (Japan), Dr. Teoh Lam Chuan (Singapore), Dr. Looi Kok Poh (Singapore), Dr. PC Ho and SP Chow (Hong Kong), and Dr. John Capo, among others.
Among the projects of the AHSP aside from holding regular meetings are quarterly round table discussions of hand cases among the different institutions across the country. In this way, they are able to promote the specialty and the local hand surgeons in the area. One of the goals of the society is to spread hand surgery across the nation so that more Filipinos will have access to specialized hand care. Past presidents of the society include: Dr. Pido, Dr. Inocentes, Dr. Leo Daniel Caro, Dr. Ida Tacata, Dr. Ferdinand Autea, Dr. Angel Gozum, and Dr. Jose Ma. Bautista.
In any great feat or achievement, there will always be people behind it that is responsible for initiating, achieving or sustaining those achievements. Hand surgery in the Philippines today would not be possible if not for certain key personalities that have dedicated their lives in developing and promoting the specialty of hand surgery. Among the early proponents of the specialty, Dr. Inocentes, would probably stand out as the "Father of Hand Surgery" in the Philippines. In the 1950's and 1960's, hand surgery as a specialty is not well recognized, and most surgeries of the hand are being done by general orthopedists and general surgeons. Dr. Inocentes went out of his way to acquire specialized training in hand surgery and subsequently established and headed the Hand and Peripheral Nerve Unit of the Philippine Orthopedic Center (then called the National Orthopedic Hospital). His interest in tendon transfers for the paralytic hand has placed him in the forefront of reconstructive hand surgery in the Philippines. His published articles on tendon transfers were to be considered as one of the first in the Philippines.The contributions of Dr. Inocentes on hand surgery has blossomed today where four hand specialists from the Philippine Orthopedic Center, the institution where he first started, are continuing his work on specialized care and reconstruction for the hand.
At University of the Philippines- PGH, Dr. Ambrosio Tangco saw the need for specialized hand surgery training and initiated the training of Dr. Jose V. Silao, Jr. to study hand surgery overseas in 1970. Upon his return, Dr. Silao became the founding chairman of the Department of Orthopedics of the University-based hospital. Following the vision of Dr. Tangco for specialized training in the hand and with the other specialties as well, Dr. Silao initiated the
training overseas of the graduates of the Department of Orthopedics. Among the early recipients of specialized training in the hand at that time were Dr. Tacata (San Francisco, USA under Dr. Eugene Kilgore) and Dr. Severino Tanbonliong (University of Tokyo, Japan under Dr. Yamauchi). Dr. Silao's influence on atraumatic handling of hand injuries has been passed down since he became the head of the Department of Orthopedics three decades ago. His devotion to hand surgery as a specialty gave birth to the Microsurgery Unit in 2005. The multi-disciplinary unit is the only one of its kind in the Philippines (alongside with the Brachial Plexus Clinic). As a tertiary hospital and a University-based hospital, the Microsurgery Unit has been the referral center for various microsurgical reconstructive surgeries. The Brachial Plexus Clinic under the Microsurgery Unit has been in the forefront in the management of obstetric and traumatic brachial plexus injuries in the Philippines. At present, the Microsurgery Unit is being headed by Dr. Emmanuel P. Estrella.
Another name that is synonymous to hand surgery, especially to the name "Philippine Society for Surgery of the Hand" is Dr. Pido. He was very instrumental in the creation of the present hand society way back in 1984 and served as its founding president. Together with Dr. Inocentes as its founding vicepresident and distinguished members like Dr. Luisito Maano, Rimando Saguin, Felix Vicuna, and Conrado de Gracia, the Philippine Society for Surgery for the Hand created its by-laws and constitution in 1985. Dr. Pido has been in the forefront of hand surgery in the Philippines and has helped build up the society since its inception in 1985 to what it is today.
The Asia Pacific Federation for Societies for Hand Therapy (APFSHT) was first organized in 2004 at the first symposium for Asian hand therapists held in Osaka, Japan. Missions of the APFSHT are to enhance and support international cooperation in clinical hand therapy and education, promote communication and knowledge exchanges between hand therapists and hand surgeons, and improve the quantity and quality of education and research in the field of hand therapy within the Asia-Pacific region. Countries of the first board of committee for the organization included Japan, Australia, Singapore, Korea, and Hong Kong. Dr. Cecilia Li (PhD, OTR/L, Hong Kong) was elected as the founding president of the federation.
The APFSHT committee works closely with the Asian Pacific Federation of Societies for Surgery of the Hand (APFSSH) to co-organize the biannual conferences held in Thailand (2nd, 2006), Hong Kong (3rd, 2008), Taiwan (4th, 2009), and Indonesia (5th, 2010). The 6th APFSHT conference was held in Kuala Lumpur, Malaysia in 2014 (October 2-4) in conjunction with the 10th APFSSH conference. The APFSHT has strengthened its body to increase members from countries within the Asia-Pacific region, including Sri Lanka, Thailand, Taiwan, Indonesia, China & Malaysia.
For more information about the APFSHT please visit their website on