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Referat fra FESSH  DELEGATES  MEETING 

Torsdag, 28 Juni 2007 – Athen

Claus Möger, håndkirurgisk sektor, ortopædkirurgisk afdeling E, Århus Universitetshospital, er udpeget af DsfH til delegeretmødet i Fessh.

Anders Ditlev Jensen, håndkirurgisk sektor, ortopædkirurgisk afdeling E, Århus Universitetshospital, er udpeget til at repræsentere DsfH i Handtraume Care Group Europe.

Hermed følger det officielle referat af delegeret mødet i Athen 2007.

Deltagere: Marc Garcia Elias (Spain), Enrique MacKenney (Spain), Mariosz Bonczar (Poland), Peter Burge (UK), Claus Möger (Denmark), Werner Girsch (Austria), Lars Eldar Myrseth (Norway), Alexandru Georgescu (Romania), Gursel Leblebiciogili (Turkey), Carlos Heras Palou (UK), Giorgio Pivato (Italy), Zsolt Szabo (Hungary), Bjorn-Ove Ljung (Sweden), Igor Golubet (Russia), Pavka Trichkova (Bulgaria), Daniel Herren (Switzerland), Janos Simonka (Hungary), Regis Legre (France), Zdenko Orozim (Slovenia), Jorg Bahm (Belgium), Thierry Dubert (France), Alena Schmoranzova (Czech Republic), Simo Vilkki (Finland), Andrea Atzei (Italy), P Houpt (Netherlands), Martin Richter (Germany), Christophe Oberlin (France), Jan Friden (Sweden).

Marc Garcia Elias commenced the meeting by welcoming the delegates and thanking them for their continuing support over the previous year. He also introduced the new FESSH Historian – Andreas Gohritz. The question of the timing of the Delegates meeting was discussed; the majority of Delegates voted to have it from 7 – 9 am on Friday next year. The Minutes from the Glasgow Delegates meeting in 2006 were approved. 

1.       Report of the Secretary General – Marc Garcia Elias

Marc Garcia Elias reminded the Delegates that the General Assembly would take place on the following Friday – in the main auditorium. Last year only 7 out of a possible 20 Presidents turned up. This year, he would like the Delegates to represent their countries.  Marc had prepared a slide for each country. The Committee Chairmen would each give a short report. The 3 Junior and 1 Senior FESSH Fellows would be presented as well as the Best Examinee. There would also be a presentation on the Lausanne (2008) meeting. 

Modifications of the By-Laws had been proposed :

-          Chairmen of the Committees to be nominated by Council – posts to be held for 3 years (maximum 6 years)

-          Secretary General and Treasurer to be elected by the Delegates; the Secretary General Post to be held for 3 years; the Treasurer’s post for 4 years.

-          Now only two types of FESSH Membership – Full or Corresponding

These modifications were approved by the Delegates.

Regarding relationships with other scientific societies – the European Wrist Arthroscopy Society wish to be present in all future FESSH Meetings and will organise a round table – FESSH to provide a room for free. Regarding the American Society for Surgery of the Hand (ASSH) – they will provide a free place at their annual conference for the FESSH Travelling Fellow – as well as helping with a visit to a hand surgery centre in the States. Application needs to be made before May 1st to the ASSH Membership Coordinator. FESSH will reciprocate by allowing the ASSH Travelling Fellow a free place at the FESSH Congress.

Regarding the IFSSH – they would prefer FESSH not to hold an annual conference in the same year as the IFSSH meeting. However, FESSH Council had decided that if the IFSSH meeting is held at a venue sufficiently distant to make it difficult for FESSH members to attend, then a FESSH Congress should still take place (but separate in time as much as possible). The next IFSSH meeting will take place in October 2010 in Seoul (Korea); therefore the FESSH meeting will be held in Bucharest that year – possibly in the springtime. Furthermore, the 2013 meeting will take place in India.

Regarding EFORT – FESSH had been asked to organise a half day session (round table) on hand surgery at the EFORT meetings on alternate years. FESSH would pay the expenses of the speakers – EFORT would reimburse FESSH 50 euros for each delegate who registers for the session.

UEMS – FESSH had been applying to the UEMS to have hand surgery recognised as a separate specialty for some time. A meeting is to be organised later in the year in Brussels, which Marc Garcia Elias, together with Frederic Schuind, will attend.

Regarding the Instructional Course Book on Infections – this has been published in Greece and is available for purchase.

The Singapore Society for Surgery of the Hand had requested for some of their Singaporean Fellows to take the FESSH exam; there had also been some requests from South America. Passing the exam would not allow them to be able to work in Europe. The applicant would need to be a member of one of the international hand societies and would also need a covering letter from their own society, stating that they had had adequate hand surgery training. They would need to pay the full price for the exam (i.e. not subsidised by FESSH, as it is for European applicants). After some discussion, the Delegates approved this proposal.

2.       Hand Surgery Courses in Eastern Europe

Zsolt Szabo is organising a basic course on hand surgery in Hungary on 8-9 September 2007 in order to provide good education for hand trainees from Eastern Europe at low cost.  FESSH will support the registration fee (300 euros) for 20 trainees as well as the cost of 5 speakers. This support will amount to 10,000 euros in total. This new initiative is to be assessed in order to decide whether to continue to support this on a regular ongoing basis.

3.       Management of FESSB

In May 2007 a contract was signed with Asszisztencia in Budapest who will now take over the management of FESSH. They will be responsible for producing the Hand Society Directories, Updating the List of Hand Surgery Training Centres, keep a calendar of events on the FESSH website as well as the general management and maintenance of the website and provide secretarial coordination and support to the Committee Chairmen and to Council. They will also provide support for the organisation of the FESSH Congresses together with a local organiser. Letters had been sent to all national society Presidents, informing them of this development. Krisztina Szigedi and Nandor Matrai from Asszisztencia were introduced to the Delegates. They have a staff of 10 people and many years experience of running medical congresses. The cost for this management support will be 1600 euros per month.

4.       New Members of FESSH

Slovenia, Russia and the Czech Republic have all been accepted as full members of FESSH. Slovenia has 40 members, Russia – 42 members and Czech Republic – 132 members. 

5.       Report of the Treasurer  - Daniel Egloff

The Accounts for the financial year 1 April 2006 – 31 March 2007 were presented. The accounts have been audited and approved. The total assets of FESSH are now 408,149 euros (they have increased from 346,197 in 2006). There are 3 different accounts, one of which attracts interest on the capital. The income from both the Glasgow and Gothenburg meetings has been credited this year. FESSH total income amounted to 113,569 euros; the income derives from society dues, the congresses, royalties (JHS and Instructional Course Book) and Interest. Total expenditure was 51,378 euros – giving a profit of 62,190 euros. There has been a saving in that the examiners have not, to date, claimed the 350 euros to which they are entitled. The amount for the Abstract book is not yet known. All countries have paid the 2006 fees and some have already paid the fees for 2007. It should be noted that the 2007 fees have to be paid before the next congress in order to maintain voting rights. If a Society has more than 100 members – they are entitled to two votes.

The budget for the 2006-07 year was 62,500. FESSH propose to increase this to 68,890 for the 2007-08 year. The Society dues of 12 euros per member will remain the same for 2007 – but for 2008 it is proposed to increase this to 15 euros. 2 members were against the increase in society dues – but the proposal was approved by the majority. 

6.       Report of the Examination Committee – Zsolt Szabo

45 applicants registered interest in the exam; of those 18 were accepted and 16 attended for the exam. The exam is now held only in English – but we try to have examiners with a variety of language skills. There are 12 examiners. There has been good local organisation in Greece. For the MCQ only 2 candidates scored less than 150 (300 being the maximum). The oral exam deals with trauma and systemic disease. The maximum points for the oral is 5 and 3 candidates attained maximum points. 14 of the 16 have passed the exam. Feedback has been given to the 2 candidates who failed – and they have the opportunity to retake next year. The best examinee this year was Patrick Hamilton Gillespie (UK). The Delegates were asked to promote the FESSH exam amongst their own society members. The Delegates were also asked to offer the names of two possible examiners – so that a database of possible examiners could be compiled. A request for MCQ questions and interesting cases was also made. Application for the exam can be made electronically – and applications have to be in by 30 January 2008 for next year’s exam.

7.       Internet Committee – Giorgio Pivato

Giorgio thanked Adria Web for their help so far with the website. However, the management of the FESSH website will be taken over by Asszisztencia – for positive reasons. It is hoped to develop projects within the website and to make it more interactive.

8.       Report of Hand Surgery Training Committee – Carlos Heras Palou

The name of this committee has changed (from Qualification and Accreditation Committee). The purpose of this Committee is to stimulate and help training of hand surgeons in Europe. There are now 3 Junior FESSH Fellowships (2000 euros each) and 1 Senior FESSH Fellowship (10,000 euros). The deadline for applications is 1 December 2007. The Senior Fellow should be aged under 40; he/she should be an established hand surgeon who wants to visit other centres to enhance his/her skills. The decision on allocation of fellowships is taken at the December Council meeting (1 December).

For this year, the Junior Fellows are: Jean Bart Jaquet, Frank Unglaub and Tobias Laurell. The Senior Fellow is Alan Hussey; he will be visiting Australia, India, Taiwan and Singapore. The 2006 Senior Fellow (Torbjorn Vedung) will be presenting his report at 1 pm in Room C.  The Delegates were asked to encourage trainees to apply; the Fellowships are advertised in the Journal of Hand Surgery in August and October and there is also information on the FESSH website. Council were asked to consider increasing the number of junior Fellowships, perhaps to 5 per annum. This to be considered.

The list of Training Centres is on the website; Delegates were asked to check the information and send any updates or additions.

9.       Report of the Research Committee – Jan Friden

The Tetraplegia and Hand Function Study which was announced in Glasgow last year is a web based questionnaire to patients. An association has also been formed in the USA. Jan Friden highlighted some of the findings so far:

-          road traffic accidents and diving accidents are the main causes of injury

-          C5/C6 are most commonly involved (70%)

-          Mean Age at injury – 25; mean Age at time of questionnaire – 38

-          Male / female split : 61% and 39% respectively

-          Spasticity – 48% - no; 52% - yes

-          Had patient heard of tendon transfer surgery – 77% in Europe; 39% in USA

-          Had patient had tendon transfer surgery – 53% in Europe; 9% in USA

-          Ability to extend elbow considered critical by patient

-          Patient willing to undergo surgery / rehabilitation in order to improve function and quality of life.

Jan Friden asked the Delegates to encourage their rehabilitation colleagues to ask patients to log onto the website and complete the questionnaire. The questionnaire is open until November 2009 and can be found at: www.fessh.com  under Research menu.

The goal is for every individual in Europe, living with tetraplegia, to be assessed by a hand surgeon with a specific interest in this field.  European countries are to be encouraged to provide this service in specific centres.

10.   Committee of the Journal of Hand Surgery – Christophe Oberlin

The name of the Journal has changed to Journal of Hand Surgery (European). The number of paper subscriptions had not changed very much – although the Netherlands had taken out a block subscription. The differences between the countries subscribing was highlighted. The impact factor for the Journal remains about the same. We are now able to assess Author Satisfaction, which has scored well. The internet subscriptions are increasing with many full text downloads. There is a package subscription for institutions and societies are encouraged to take out ‘en bloc’ subscriptions. There is a discount of 77% for national societies.  (40% for individuals). The top 10 downloaded papers are to be presented on Saturday morning, and this will become a regular feature of the FESSH meetings.

Chris Hammond from Elsevier was present at the meeting and he also asked the Delegates to consider bulk subscriptions as this is a considerable benefit to the members. The Journal is developing a much better web based portal. There is approximately 35 years of content available.

11.   Hand Trauma Committee – Thierry Dubert

20 out of 21 countries have participated in an audit of hand trauma centres in Europe. A report is to be submitted to the Journal of Hand Surgery. There was a hand trauma committee meeting this morning, at which 16 countries were represented. A useful network is developing with an extensive record of the various centres. There are large difference in provision of hand trauma care in the different countries. Hand Trauma definitions need to be clarified. The Trauma Committee is developing Accreditation Guidelines. Delegates are asked to maintain links with the trauma committee representatives from their own countries. Ph Bellemere & T Kaleli had designed an accident prevention logo, that could be put on all electrical tools etc.

12.   Lausanne 2008 FESSH Congress :  - Daniel Egloff

The next Congress will take place from Thursday, 19 – Saturday, 21 June 2008 in Lausanne. Main topics will be Tendon Surgery, Peripheral Nerve Surgery and Aesthetics in Hand Surgery. It will be a combined meeting with the Hand Therapists. There will also be a new session on ‘Switzerland’. Details are available on the website at: www.eurohand2008.com.  15 November 2007 is the deadline for submission of Abstracts. 

The Welcome Ceremony will be held at the end of the first day; the Gala Dinner will be on Friday, 20 June. There are various possibilities for sightseeing tours. Hotel rooms can be booked now and it should be noted that the Congress dates are at the same time as the European Football (there are matches in Geneva) – therefore early booking may be advisable.

There will be an art contest, open to all delegates and with a prize for the best submission.

All Delegates are invited to the Presidents Dinner.

13.   Future Meetings :

Poznan in Poland will host the 2009 meeting; the topic will be: Technical Tips for the 10 most common hand surgery procedures’; there will be a pre-congress meeting on shoulder and elbow surgery.

The 2010 meeting will be held in Bucharest, Romania – the topic will be: Soft Tissue Coverage of Mutilating Injuries of the Hand.

For the 2011 meeting – there had only been one bid – from Norway; this was accepted as the venue for the 2011 Congress, following a presentation. The dates will be 25-28 May 2011 in Oslo.

14.   Hand Surgery Projects

Joe Dias (UK) presented a proposal to improve hand surgery care in Europe. He proposed to link the FESSH Congress to a specific project, with the aim of improving hand surgery care. However, the general consensus was that it would be difficult to take on the organisation of a congress at the same time as organising a major project – and this restriction may prevent some of the smaller societies being able to bid to host a Congress.  However, the principle was accepted as desirable. There are three projects running currently: Zsolt Szabo’s education project, Jan Friden’s Tetraplegia project and Thierry Dubert’s work on Hand Trauma. Discussion ensured as to whether a new Committee could be established to take on such a project – or whether this should come under the umbrella of the Research Committee. Delegates were asked to try to identify a project, that could potentially be supported by FESSH.