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German Hand Trauma Alliance - Current Status
Riccardo E. Giunta, MD, PhD
Handchirurgie, Plastische Chirurgie, Ästhetische Chirurgie, Klinikum der Ludwigs-Maximilians Universität München, München, Germany

Severe hand traumata have a significant impact on our health system and on insurance com- panies, respectively. It is estimated that 33% of all occupational injuries and 9% of all invalidity pensions are due to severe hand trauma. Unfortunately, these high numbers are not only due to the severity of the trauma but to organisational deficiencies. Usually, the patient is treated at the general surgical emergency in the first place and only then forwarded to a microsurgeon. This redirection increases the time that is required for the patient to finally arrive at an expert for hand surgery. On the one hand, this problem can be explained by the population's lack of awareness for distinguished experts for hand and microsur- gery, on the other hand, the emergency network, or emergency doctors in particular are not well informed about where to take a patient with a severe hand trauma – clearly a problem of com- munication between the hospitals and the am- bulance. It is possible to tackle this problem, but put participating hand trauma centres have to work hand in hand as a network and thus exploit synergy effects. The French system "FESUM" is a good example for such a network and even com-prises centres in Belgium and Switzerland. To improve the treatment of severe hand trauma, a similar alliance was initiated in Germany just recently. The pilot project "Hand Trauma Alliance" (www.handverletzung.com) was started in April 2013 and currently comprises two hospitals within the region of upper Bavaria. The network provides hand trauma replantation service on a 24/7 basis and aims at shortening the way from the accident site to the fully qualified hand sur- geon, to improve the therapy of severe hand inju- ries and to optimise acute patient care in general. In order to further increase the alliance's impact it is intended to extend the project's scope from regional to national coverage – nevertheless, such an endeavour can only be done in collaboration with the German Society for Hand Surgery (DGH). This paper reviews the current status of the german Hand Trauma Alliance effort.

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