[Humanitarian surgery of the hand. Our experience in Vietnam]

After a general presentation of the geographical and social aspects of Vietnam, the authors describe the conditions of their surgical work during short time humanitarian hand surgery missions. These missions, lasting 7 to 10 days are dedicated to the care of children, and a half-day of teaching for Vietnamese corresponding surgeons. The technical and material limits, the constraints for the patients to travel to the hospital, to pay for care and the difficulties of follow-up, require the selection of patients in whom the disease can be treated in a single stage procedure. Three types of diseases were treated: congenital anomalies, post-burn and post-trauma sequelae. Typical cases of these diseases are described and shown. Due to the absence of hand rehabilitation, reconstructive tendon surgery is inadvisable to avoid disappointing poor results and discredit this part of hand surgery. For reason of complexity and unreliability of electromyographic examination, brachial plexus injuries cannot be treated, except the simplest cases needing one or two tendon transfers. Concerning skin coverage and reconstructive surgery, our experience has shown that pedicled local and locoregional flaps, and even microsurgical transfers are adapted and reliable techniques due to the imperative of single stage procedure. The education and teaching of young surgeons in European teams and regular relation-ships with corresponding surgeons from developing countries are certainly the best way to promote humanitarian hand surgery.