Hand surgery network


There are 1,4 million hand trauma and injury cases in France every year; 620,000 of them include potential financial compensation, i.e. a 25% increase over the last five years.

This compensation represents 80 to 96% of total cost for hand trauma (Raimbeau 2003, Rosberg 2005, Trybus 2006).

The structure of the hand consists of a large amount of small articulated bone elements, a synovial and tendon system, a large amount of blood vessels and nerves and the particular sensitivity of the covering skin.

Hand trauma represents a real challenge for public health. A nationa-wide Hand Surgery Network has been set up.


Hand TraumaHand trauma and injury figures

  • FrequencyIt represents 15 to 40% of trauma emergencies
  • 25% of accidents result in medical leave
  • 26% of accidents result in permanent disability
  • 16% of work days lost are due to a temporary disability
  • 16% of rates resulted in permanent disability

According to a study by the European Federation of Hand Emergency Services (2002) hand trauma accidents can be classified as follows:

  • 28% are work related
  • 62% are domestic related
  • 10% are road traffic related

A press release issued by the National Academy of Medicine on the 29 of June 2004 clearly explained the problems raised by Hand and Upper Limb trauma:

"Hand injuries account for a very high percentage of all trauma, approximately a 25%. They cause long-term medical leave, serious permanent disability and traumatic professional downgrading among manual workers. A precise diagnosis (sometimes difficult as a minimal wound can hide a serious injury) and surgery require complex microsurgery techniques for emergencies. They are likely to reduce disabilities. Less than 10% of 1.400.000 hand injuries every year in France are treated by specialized institutions. Many public hospitals are not capable of treating the challenges which emergency hand trauma presents.

The average cost of a patient suffering from a DIP dislocation higher or equal to 10% is 85 405 Eurofor the community.

Goals of the Hand Surgery Network

Our network reduces after-effects by providing a good orientation to patients in emergencies and a better coordination between all those concerned with medical care. In cases of physical after-effects, our network reduces their seriousness. By doing that, the duration of medical leave is also reduced by coordinating the work of social occupational professionals and psychologists.

The network introduced the following innovations:

  • follow the patient care program and evaluate costs.
  • coordinate hospital and council-related areas
  • ensure continuity of health, social and professional care
  • gather initiatives defining common goals which are agreed upon by all professionals.
  • Provide health criteria and organize coordination,
  • Establish an information system helping to provide and lead better health care
  • Provide a comprehensive and coherent information system to organize work.

Advantages for Patients

  • Coordination : We link with the city´s professionals who are involved to provide a return home.
  • A follow up: Support and advice are provided by regular contact between the medical-social assistant and the patient.
  • Evaluation and orientation towards the best-adapted institutions.
  • A 9 am to 6.00 pm phone line on work days. (This might be expanded if outsourced).
  • Psychological help
  • Social help: the medical-social assistant evaluates the general condition of the patient to orientate him/her towards the institutions that best fits the patient´s needs to reduce medical leave time. This assistant may help the patient with administrative procedures.
  • A directory of health professionals is available.
  • Access to an occupational therapist
  • Improve the access, the understanding and visibility of the services offered
  • Access to quality and community health care
  • Comprehensive information and training (poster campaign, Website, information exchanges for occupational health doctors and in accident emergency departments)
  • Training course on "remaining in employment" methodology
  • Problem solving strategies for the most complex cases
  • Prevention through communication measures

Services For Heath Professionals And Institutions:

  • Coordination: we distribute information among professionals, hospitals and city authorities.
  • Professionals benefit from support and advice; we make suggestions to help decision making
  • Training: we organize training on hand and upper limb surgery for professionals
  • We share best practises codes: we share validated healthcare protocols on hand and upper limb trauma treatment
  • Work groups
  • A directory of health professionals is available.
  • Centralized availability management of medics and paramedics belonging to our network
  • Group training to improve the technical skills o our medical an paramedical professionals.
  • Better access to emergency services organized by different levels of specialization to avoid incorrect initial assessments.
  • Access to health care protocols
  • Access to a Website
  • Problem solving strategies for the most complex cases
  • Anintegrations of the different disciplines involved (social, medical, paramedic, psychological, socio professional, etc.)
  • Continuity of care after hospitalization
  • Working integration of professionals from different disciplines
  • Organization of the best possible home return for patients and help to remain in employment.
  • Identification and solution of health, social and psychological problems which prevent patients from remaining in employment.
  • Improvement of admission conditions by providing the right orientation from the emergency stage.
  • Improvement of psychological care of patients and their families.
  • Improvement of physiotherapy and nursing care
  • Improvement of community health care
  • Measurement of the network´s costs and benefits (from admission)
  • Improvement of health professionals participation in the network
  • Improvement of health professionals´and patients´ satisfaction
  • Organize permanent care via coordination
  • Allow easier access for patients to independent health specialists, where quality of care is guaranteed by training and feedback from both internal and external evaluations according to the most upt-to-date recommendations.
  • Meetings and Website organization for networking purposes among members
  • Practice standardization using common tools to carry out clinical and epidemiological evaluation
  • Organize information campaigns to increase patient awareness

More information on the Hand Surgery Prevention Network:


This network is the initiative of two SOS Mains (hand emergency) centres in the Lyon region.

  • Hands Are Us - Lyon (Villeurbanne).
  • Edouard HERRIOT (Lyon) Hospital directed by Gillaume HERZBERG MD, financed by the Hospices Civils de Lyon.

Doctor Lionel ERHARD, member of ICMMS, is the GCS Hand Surgery Network Prevention Rhone Alpes Auvegerne administrator.

He is assisted in this work by :

Click here for more information on the Hand Surgery Prevention Network in the Rhône-Alpes Auvergne Region

Content modified on 02/12/16