Hand reconstruction.

To conclude, one must apologize for having introduced so many subjects and left so many loose ends. Hand reconstruction poses a multitude of problems which are presently in an evolutionary phase. In discussing the notion of hand surgery specialization one draws upon orthopaedic, plastic and microsurgical techniques. But is it not precisely this adaption of diverse techniques to one organ which constitutes a speciality? Rapid progress in hand surgery was achieved the moment surgeons confined the major part of their activities to the treatment of this organ. But let us repeat that progress implies collaboration and not isolation. Advances highlighted in this review resulted mostly from collaboration between the laboratory and the operating theatre. It is worthwhile creating hand centres not only for the benefit of patients but also for research and for training surgeons. These centres must become places of collaboration between numerous clinical and preclinical specialities: namely orthopaedics, traumatology, plastic surgery, rheumatology, neurology, physiotherapy, and applicance makers, as well as biologists and anatomists, all applied to the reconstruction of the hand.