AADO Asian Fellowship Programme 2010
A Report from Dr. Sarvdeep S. Dhatt
03 May - 28 May 2010

It is a report from Dr. Sarvdeep S. Dhatt, one of the successful applicants of AADO Asian Fellowship Programme in Queen Elizabeth Hospital at Hong Kong, who had a visit there on 03 May - 28 May 2010.

I was offered this fellowship in Jan 2010 and didn’t think twice before saying yes. When one thinks of Hong Kong, its reputation proceeds itself and the values of discipline and the methodical approach to life come to mind. With these same thought's in mind I consented to take part in this fellowship. Right from the secretarial level upto the fellowship director, there was no confusion or any other problem with the correspondance. Here I would like to commend Ms Kellan Cheung and Ms Terry's help in arranging the training visa. After recieving my training visa I headed off to Hong Kong from Delhi, India for a four week fellowship at Queen Elizabeth Hospital.

From the first day onwards and till the last day, the trauma team headed by the dynamic Dr Shen and ably supported by Dr Lee, Dr Ivan, Dr Gary, Dr Edmond, Dr Diane and Dr Marcus made our stay very comfortable. Small things like getting us acquainted with the locker rooms to the OT complex, we felt very comfortable.

The basic routine started with a daily pre - operative ward meet at 8 am where we discussed all the cases to be done on that particular day including implant related issues. The hospital has an excellent OT – Ward digital record system known as OTMS by which one can recall all records including x-rays to other investigations. This system really makes pre operative planning a dream and should be a must in all set up's. After the ward meet we took part in a very informal class with Dr Shen, who introduced us to a very basic approach to his never ending collection of case studies. This class was very good and informative and Dr Shen very patiently heard our problems and gave us endless surgical tips and pearls. After the class we went to the Operation theater to observe the surgical cases. We were pleasantly surprised to see a very amicable and conducive atomsphere in the theater, with all staff very well trained and all doing there designated duties very well.

Considering the amazing life expectancy of the Hong Kong residents, this particular hospital deals with around 750 – 800 geriatric fractures per year. This problem needs alot of team management and a sound solution considering the economic and social repercussions and this exactly is what they have achieved here at this hospital. The ideal solution means a quick sugery with minimal blood loss and also a stable fixation by which we can offer the patient an immediate weight bearing and good rehabilitation. This solution is the cephalomedullary nail in the form of the gamma nail. To say the trauma team has perfected this procedure is for every one to see with there own eyes. The first gamma nail surgery we saw was done in 9 minutes! And over the next few weeks we saw reproducible results every time. The surgeons taught us the importance of pre – operative reduction and the tips of nail insertion as well as the hip screw insertion. Keeping a TAD of less than 10mm in both views is more of religion in the team, and this practice is one of the reasons of there amazing results.

Besides hip fractures we saw fractures involving femur, tibia, ankle, patella and the upper limb. The trauma team were always teaching us thought out the surgery itself and also later in the lounge room. This made us feel very warm and comfortable and didn’t make us feel away from home. They were also very cordial and took suggestions from us also and never did we once feel that we were forced upon on any particular type of implant or approach.

On Wednesday's we had the ward meeting to discuss the last week’s surgeries. This meeting was very good and we all gave our constructive criticism which was well taken by everyone. After that we had the out patient clinics where Dr Shen again patiently showed us presentations and follow up's of various patients. Giving a good result in the end is more important than just giving a good post Operative x-ray. After seeing the follow up's we were very impressed with the surgeries. Dr Shen taught us the methodical approach to any case including the concept of "span – scan – plan" by which any hard scary case can be dealt very well and easily.

In the end I would like thank the trauma team for making our stay comfortable. We came as strangers but leave with a sense of sadness after making such good friends and I would also like to thank AADO for having such a good trauma fellowship and giving me an opportunity to be part of it.

Dr. Sarvdeep S. Dhatt
Department of Orthopaedics,
PGIMER, Chandigarh India
+91 – 9815126600, +91 – 9914208477
sdhatt@yahoo.com