Oxford And Leiden Give Course Trauma Surgery On The Hand And Wrist

E. van den Brink, Oxford And Leiden Give Course Trauma Surgery On The Hand And Wrist, Journal of Leids Universitarir Medical Centre, 11 July 2009, Number 6

Oxford And Leiden Give Course Trauma Surgery On The Hand And Wrist


Hand in hand


On 25 May, the Orthopaedics Department of the LIJMC, together with orthopaedics from Oxford, organised a special course day on trauma surgery on the hand and wrist. The participating orthopaedics and orthopaedics in training were very enthusiastic, so that the initiative will certainly be continued. by Els van den Brink photo Marc de Haan


Ai since 1946, Leiden has had a city link with oxford in England. Both cities are university towns, and both have a large university medical center. More than 7,000 people have participated in community activities over the years. But the LUMC had never made concrete use of this twinning — until now. Zulfi Rahimtoola, hand surgeon at Oxford (and trained at the LUMC) and orthopaedic surgeon dr. Huub van der Heide (Orthopaedics) took the initiative for a joint hands-on course in the field of trauma surgery on the hand and wrist, in which students follow not only lectures but also practical surgical training in the cutting room. Van der Heide explains: "There is a shortage of training at this level. There is a lot of practice with plates and screws on plastic bones, but then you do not take into account the soft tissues that are around it in real life, such as nerves and tendons. " In this course, a lot of attention was paid to that.


Better facilities

The organizers deliberately chose to hold the course in Leiden and not in Oxford, mainly because of the surgical training in the cutting room. "In England, this is a lot more difficult from a legal point of view, and there are far fewer people there who make their bodies available to science after death," explains Van der Heide. The LUMC has very good facilities for surgical training. For example, there are operating lights with a camera, so that students can watch on a screen when a teacher does something. For this occasion, there was even rôntgen equipment available in the cutting room. Six students from Leiden and six from Oxford were allowed to participate in the course.


Territorial battle

Trauma surgeon Kees Bartlema was one of the four speakers during the course day. Bartlema: "In the Netherlands there is still sometimes


Figure 1 Surgical training during the course


a kind of territorial battle going on between orthopedic and trauma surgeons over who should treat bone fractures. At the LUMC, on the other hand, we work together very constructively. For example, we participate in each other's training courses and also work closely together in direct patient care, such as in the multidisciplinary hands-trauma team." And therefore also during this course.

He treated the two most common hand and wrist bone fractures: in the wrist and the carpal bones. For example, the students practiced an operation through the inside of the wrist.  Van der Heide: "There are many important structures such as vessels, tendons and nerves towards the hand. To repair a fracture, you need to choose a path to the bone without damaging those structures. During the training we can demonstrate this beautifully, after which the doctors can practice. They are also introduced to new implants." Bartlema adds: "The orthopaedics from Oxford are very experienced. They were able to give a lot of explanations that went beyond the textbooks, with practical tips and tricks, and they warned of pitfalls." The students were able to put this knowledge directly into practice during the operation training.


To be continued

Bartlema and van der Heide expect that the course will be continued in several ways. In any case, the intention is to repeat the course in one or two years. In addition, the course could also result in an exchange of students and doctors in training to become specialists (AIOS). Bartlema: "Networking was also an important aspect of the course. In Oxford, a lot of trauma surgery is done, while in Leiden more secondary hand surgery takes place, for example in rheumatism patients. An exchange of AIOS could benefit patient care.  Agreements have already been made with various AIOS from both Leiden and Oxford about this."