Pioneering Excellence in Hand Surgery Across Pakistan

Pakistan Society for Surgery of the Hand

A perspective Hand Surgery in Pakistan has daunting challenges and exciting possibilities. As an organised surgical field, it started with the first meeting of Pakistan Society for Surgery of the Hand (PSSH) in November of 1993 at Bahawalpur. Founding members were: Abdul Hakeem Babar, Muhammad Umar, Muhammad Saleem, Tariq Suhail, and Tahseen Cheema. From a humble start, PSSH has grown into a vibrant professional organisation that is ready to meet its obligations and challenges posed by peculiar circumstances and blend of pathology prevalent in Pakistan.

Patron-in-Cheif (PSSH)

While Pakistan has many skilled hand surgeons, dedicated hand surgery centers remain scarce, with CMH Lahore being the only specialized facility. This lack, coupled with overwhelming industrial and agricultural trauma, severely impacts the most socioeconomically disadvantaged. Over the past 25 years, shifts such as the rise of cerebral palsy and brachial plexus injuries—exacerbated by urban growth and increased motorbike use—have posed new challenges for our medical community.

Although there are individual success stories in surgeries like replantation, widespread efforts are constrained by limited resources and disorganized systems. Unsafe machinery further contributes to devastating injuries, underscoring the need for better safety regulations.

PSSH is focused on expanding specialized centers, advancing surgical training, and developing allied disciplines like hand and occupational therapy. We are determined to convince societal and political leaders to prioritize hand surgery as a means of protecting our workforce. With strategic organization and emerging leadership in the field, we are confident in building a future where optimal hand care is accessible to all. Our past achievements are just the beginning.

Centers

Establish specialized hand surgery facilities nationwide for better access.

Training

Enhance surgical expertise through focused education and research.

Safety

Improve industrial and agricultural safety to prevent injuries.

Rehabilitation

PSSH aims to integrate therapy programs for comprehensive patient care.

PSSH Vision

Key Challenges:

1. Lack of Dedicated Centers:

- Only one dedicated Hand and Upper Limb Surgery (HULS) center exists in CMH Lahore.
- Need for additional specialized centers for microsurgery and trauma management.

2. High Trauma Load:

- Industrial and agricultural accidents disproportionately affect the socioeconomically disadvantaged.
- Unsafe machinery, poor regulations, and lack of safety measures exacerbate the issue.

3. Emerging Pathologies:

- Transition from polio to cerebral palsy, which is more complex to manage.
- Brachial plexus injuries caused by chaotic traffic and increased motorbike usage.

4. Limited Resources and Organization:

- Current management is resource-strained, reliant on heroic individual efforts.
- Lack of structured systems for replantation and advanced surgeries.

5. Lack of Allied Disciplines:

- Scarcity of hand therapy and occupational therapy resources.
- Limited support for post-operative rehabilitation.

Accomplishments and Opportunities:

1. Historical Milestones:

- The first replantation of a severed hand in 1988 at Bahawalpur.
- Pioneering efforts by the Pakistan Society for Surgery of the Hand (PSSH).

2. Growing Expertise:

- Surgeons across Pakistan capable of performing advanced procedures.
- Increasing professional vibrancy within PSSH.

3. Vision for Improvement:

- Establishing 3–4 specialized microsurgery centers to centralize expertise and optimize outcomes.
- Promoting safety regulations in industrial and agricultural settings.
- Advocating for political and societal support for better hand surgery facilities.

4. Focus on Training and Leadership:

- Commitment to professional development and training the next generation of hand surgeons.
- The emergence of capable leaders within the PSSH.

PSSH Mission

Future Directions:

- Build dedicated hand surgery centers in major cities.
- Develop structured microsurgery units for consistent replantation and brachial plexus injury management.
- Advocate for auxiliary disciplines like hand therapy and occupational therapy.
- Improve industrial and agricultural safety standards.
- Engage society and policymakers to prioritize the preservation of hand functionality.