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A-1128 Honorary Lecture: The human hand: the most wonderful tool of nature
Zsolt Szabo, Miskolc, Hungary
Thursday, June 14, 2018 · 2:31 p.m. · 20m 33s
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your audience i will start this lecture of mine because a
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lot of friends of mine are asking me why hand
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surgeries a separate especially t. y. and a lot of people even today they do not know that surgeon
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why not operating hand so he's a surgeon has a surgical that one
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while he's not doing hand or why he's results are not so good of like that
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hand surgeons results and we are doctors and your years here
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we know what is the genetic of start of hand
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this wonder of the nature how it starts from from one
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little nothing from one legal cellar and of course
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the final hand to hand is the result of a lifetime work
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because we always like to put these two things together
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hand and work and it's interesting but we
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have to rely is that the only organ which is exclusive to humans is the hand
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all other organs are present in different man hours different animals
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but hand it's proper only to the man and even
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the gory loud the chimpanzee the apes are do not have hand if you look to that small town
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does all the muscles which are needed for good opposition and you look how gorilla is
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grasping sayings you will understand why we can say that that's not the hand that
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four fingers the fees doing almost messing and of course as we said
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the hands are always combined with the work with making
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sensing and there isn't it oh no discussion
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what was first hand or the two just like discussing what was forced the egg or the hand
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why do we have hands because we started to use
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it's in the stone age some some some still will be sees like tools
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or why so it's really difficult to answer to that and everybody who's here except that hands are important but
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are they necessary can we have a quality life result hands or result pansy
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disaster is tomorrow i will lose my hands what will happen to me
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and of course it's a disaster but we have a lot of examples when
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people can leave very high quality life we can make nice pictures they can make even to to us
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and of course they can drive an aeroplane result having hand it can
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have licenses for that and of course they can make wonderful paintings
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and also one of the most appreciated guessed from chefs in
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the war monitor he or she is became one of
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the most famous coax without having hands because he except that
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fact that only disability life is a bad attitude
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and not losing your hand it's and we see that result hand somebody can be very very happy
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and even without hanson lack somebody can help solve
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isn't of people like eating motivation speeches
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those people to have all their hands and all their names and that not
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one percent as happy as that guy is out any kind of line ups but of course
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human he was always fascinated by hanson humans even three million years ago
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we're fascinated by their hands and they wanted to make prints of their head and
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we see that the proportion three million years ago was the same as null
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these are about to be down and revel shorting hours and weekends make us human
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dior ancestors finish the crime after the three is enabled them to become that
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uniquely in cartesian social adaptable primary that go on as the plan
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we don't know all about what we mean sink is true is that
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still on tool manufacture larger brains and human hand anatomy evolve together
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maybe not for shore maybe they re some relation in between these
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three sinks because hand is more complex than that too
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it's not just something mechanical but to some sink because we can use in a very very
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different place sees the beginning we've also been using those has to communicate by gestures by
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letters and this is a wonderful tool to speak for those who cannot speak because
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of their disability and hands up only for communication attends our our second hearts
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these are second as we can read we can use the music and we can do
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fantastic sinks and of course human hands at the best thermometer in the war
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they can't feel if something is called something useful
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and that's all that human hand and we should not speak about all the gestures we can do
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with our hands all the lab all the passion can be expressed only by one touch
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so if we sink that hands are on your tools then we make a big mistake
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if you make the journey to the human brain and it's not a philosophical journey
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button evidence based scientific journey toward brain then
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we are looking and we can very valid attacked the cortical representation of the human hair and it is
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a big surprise for us that or tom has to be just a
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presentation on our cortex so brave and hand they're working together
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the largest part or a brain is taking care of our hand
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including mall tour and including sensitive part and if we would make
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the hormone cost based on the code to cover presentation it would look like base
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funny not some organs we think they are very important look very small here and others
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we don't think they are so important are really well represented and more important so
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if we can put this question is the technology of all days when we can solve everything backup smart phones and
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every can communicate and we can look and we can do when we can really go to other planets
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are we able to make an artificial hand to reconstruct
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this wonderful pool of the nature of course reconstructing
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the last names was an old challenge and usually these are only mechanical tools these or some
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mechanical tools which were good to hold on grass of
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the sport this ward or to protect yourself but
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it was very very short time needed to that fact to real ice
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that hand is is far not a mechanical problem
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the speak only about mechanics we can produce very strong prostheses which are how the times stronger than a human hand
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but it's not only mechanics because when they relied that's very simple movements very
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simple gestures we're doing every time in our everyday lives there so complex
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they need dozens of small tours dozens of different mechanical part dozens of different sensors and they seem to
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just to just to drink water what the complexity of technologies needed to reproduce it and of course
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to construct oppressed these of thought hand not only muscles but
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also brain i technology coordination and everything he's you
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have you ever tried to use the prostheses the seasons we
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still movements and then more complex one piece for movements
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and then don't discuss about the other complexities men movements are exponentially exploding it's very very
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difficult and the simplest but most complex part of our hand is offering that they
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those simple tricks that you can make a simple dressing and it will heal any to recover
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you know how difficulties for technology to reconstruct the to have
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breasts or sensors laughter millimetres included to have everything when
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you can detect every seeing what's also able to detect
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with your fingertips to reconstruct this technologically is really
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a fantastic challenge any our life went robotics are exploding
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to have a real hand is very difficult and i'm convenes then i'm
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conveys that we're very very far from really everyday usable device
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which can be called good hand prostheses i have patients who
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made all their savings in fantastic prosthesis they can make
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a fantastic demonstration the congress and when they go on to take it off and they're working without their prostheses
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so we are far from that the biggest problem is when this wonderful tool get injured if you look to the nature of the hand you're
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just type in google search injury of the hand these will be the
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first light switch came all and then you realise that injury
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it's changed a lot in the last only my life for the last thirty years of
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experience because even flash even you and we are working hard on prevention measures
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and when you see these tools indiscretion facilities relies it's not anymore
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the saying that big industrial amputations and fantastic big injury problems but mainly
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and housekeeping and going home and working whole result the
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knowledge top work the majority of injury happens
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and if that been hand surgery that's the first page will come on in the
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work so for people who have no idea what's hand surgery that's hand surgery
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look carefully is this really hand surgery and this is also hand surgery yes this
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is also hand surgery and hand surgery surgery which is taking care of hands
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and sometimes taking care of special hand conditions and some fancy special conditions
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you know very well that making hand surgery introductory lip this fantastic results are we do indeed
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frequently regular basis not at all but it's cool it's interesting it's possible it was that
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so if you really want to know what these hand surgery in what we're doing in our everyday activity the best
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short statement is in the white board had surgery for the european board of hand surgery kind
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surgeries the field of magazine that they use these problems of the hand and raised
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congenital traumatic degenerative inflammatory tomorrow origin and the peripheral nerves of the leaps
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and should be a plastic surgeon what you should do or topic surgeon that's not important because the hand surgeon
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and who can call himself hand surgeon who masters micro surgery
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as well as of puppy week and plastic surgery techniques
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and a huge amount of knowledge in hand surgery is there and flash is
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working hard and in my lifetime i really dedicated a lot of time
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to change the examination to introduce these european diplomat to make it a different
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as it was and then really happy that these big challenges continually
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because somebody who has these type format does not means he's a fantastic very good but it means that has
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a certain level of knowledge that we can take care of my hand of your hand of our hands
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and i'm really happy that we have a country in your switzerland
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who already accepted these european diploma as its mission all
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examination diploma so probably i surgeons switzerland just need to have the syrup in people mix and
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match and of course all you are here in the congress because you want to learn
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and we have one common goal all car a better outcome of our patients
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and to me also in all my life time i was passionate to
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make better operations to treat better my patients as you are
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and i think that in this process to treat well my patience the decision making is that
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the most importance that and there are a lot of the box and the dairies
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john out and their annual meetings which of dealing with medical decision
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making because medical decision making is a very difficult one
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how you choose what method of treatment to put for that
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condition it's very very difficult you have to learn it and we or me as a simple guy i
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was thinking in my life still now that uh it does it does that is important and
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is the most important and last year i was organising the conversant with the best dealing with having
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those base dot that hand surgery and the subtitle was do we have it do we needed
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i'm absolutely calm things now that we don't have a and b. i. to be don't need
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we like to have it but we don't use it because it was difficult when my resin
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i like very much you know plastic surgery corporation flat medical slaps and free flaps and
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doing free best rides rough for safely nonunion two years old and
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my resident asked me what should we do in this situation
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forty five years man whose work work with two years old
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normally space k. fig nonunion this vest to approximate pork
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so what to do only however type screw and do nothing or numbers correspond refuse enough we should put the
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best possible draft and of course majority of people say yes a basket has been rap is better
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if you have looking girl it would be too heavy those base that people we know
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who are my friends why can discuss ways and and a good place not
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lining i said is it true that only the habit type screw you can have
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one hundred percent would result instead of course yes so and then it's interesting
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it was very very interesting that no that's about one draft all patient it means one hundred percent so
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there are people and surgeons who cancelled every safely nonunion with normal that's what i've been draft
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and then let's go for bills quite doing press scroll arise bone graft petticoat
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only sixty nine percent of union and go to mail plane
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expressed by bone graft seventy one percent of union
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and of course it's interesting best that bone graft healing rates are up to
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eighty three percent so then that's going to be even for that we like to put basketball craft from the reviews
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because it's one incision but if we do these we have other friends like out she was great actor surgeon
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if he's doing from here then he has only for heating soft ten which
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means forty percent but if it takes a vascular graft from the
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gone by femoral compile than cats hundred percent healy so i would like to repeat
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my presence question asked me professor why we should do
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best those monograph when forty to eighty three
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percent of good results instead of doing the simple screw and having one hundred percent good results
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it's a hard question it's hard to answer is difficult to answer to that of course we
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can find philosophies hard plastic to that but in reality the reality is that we
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i would like to have evidence base that what we do nothing to have every there's base
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that are in when we have a there's base that that mainly we don't use it
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and we do not change our directives because medical decision making
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for hand surgery and for other surgical specialities is based on three very important pillars
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one is best evidenced clinical evidence bought there is indeed will clinical expert ties
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when i seen that what i was told what i'd like to do
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i can do we have the percent perfectly and the other is the patient
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values and expectations patient would like artist topical we'll go for after topical
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you know it's interesting and then don't discuss about that possibility that maybe instead of a screw
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i'm doing a free drop i do get paid ten times more maybe i don't know
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really influenced my my my decision
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i don't know
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so i'll go into that situation we see that this wonderful pull of
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the nature is something that that all mechanical you can not disease
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so the hand is wonderful when there is a brain in the middle so we
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need that also and you see that to time always use it hand
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to to project ark to project sensation to project nice sinks and lotus times
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was related to religions and even to the hand of both pieces
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tara and the hand of due to have and the hand on
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the topic church in roll over the hand in stumble it's
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fantastic tool in different of what religion is representing and if it's holding us walked or it's
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something i guess very yours hand representing or just the hands of bills
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over leading and winning the first anti socialist revolution revolution product
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or just the hands when they show the hands of somebody who is dying
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and of course hands can remember us about the big the states what will kindly like the whole cast
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and hence also can remember us about whole friendship can be strong and how
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results in good and big results can be reached when we are together
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and i think that has a perfect to demonstrate the most important activity of of human kind is wine meeting you know
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and grapes and wines this is very important to make friendship to sit
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down and to discuss i not only rash and not only
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i don't have time for this for that for that take a bottle fine and have time
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for your friends and for the family and those hands are backing up button for something
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and there are some other countries where hands demonstrate technical sinks
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there are some other countries are there simply be so far and
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roll then made fantastic sculptures even here in copenhagen you can see a lot of rodin sculptures in the museum
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it was going and sitting there about every every step and when we think about this wonderful too
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we can see that the narrative that kind was built by time chess insurrection little cannot be tested already five
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such nature approach as a lot of people who believe in darting basing that natural selection
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all these could have created an engineer ten it's because natural selection is the fact that does not create
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it only selects from what already exists and can not at the new information require
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so the whole hand possible are your has the result of map chance
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or had your has been designed in advance he's instruction for the correct soundly of
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parts goal being to be any language from the beginning is the bible
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is darlene with getting the last or i think it's not important for us the most important
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is that you have to know that when we are in the hands of got
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and all our life to sacrifice to save and to make it safer and better and
Conference Program
A-1127 President's Lecture: What 37 years with Hand Surgery have taught Me: Controversial Procedures that I still Perform and Procedures that I have Abandoned
Michel Boeckstyns, Copenhagen, Denmark
June 14, 2018 · 2:04 p.m.
137 views
A-1128 Honorary Lecture: The human hand: the most wonderful tool of nature
Zsolt Szabo, Miskolc, Hungary
June 14, 2018 · 2:31 p.m.
A-1129 Past, Present and Future of Hand Microsurgery
P. N. Soucacos, Greece
June 14, 2018 · 2:52 p.m.
A-1130 The Future of Hand Surgery
Henk P Giele, Oxford, UK
June 14, 2018 · 3:21 p.m.
226 views