Overview
 Hand Surgery has a very strong and deep-rooted foundation in the history of Orthopaedics development in Hong Kong coincided with the era of industrial blooming in the 70s and 80s. Since the inception of the department in 1983 under the leadership of Professor PC Leung and Jack CY Cheng, there had been extensive service development, researches and publications in microsurgery, congenital hand anomalies, tendon and nerve surgeries, as well as innovative flaps and grafts for complex reconstructions. The establishment of the replantation service since 1984, the setting up of the “Special Hand Clinic” and the “Congenital Upper Limb Anomaly (CULA) Clinic” in 1985 accelerated to the formation of a dedicated “Hand Team” in 1987 headed by Professor LK Hung, when all hand conditions were put under the sole responsibility of the team. In 1994, Dr. PC Ho joined the team as a senior medical officer and later succeeded Professor Hung as the team head in 2007 till 2020. Dr. WL Tse joined hand team as fresh specialist in 2003, and succeed Dr. Ho as team head since 2020 till now. For almost 40 years, Professor Hung and Dr. Ho successfully introduced endoscopic and arthroscopic surgeries in the upper limb and became pioneers and leaders in the field internationally. Update, the scope of service and research extends to elbow surgery, small joint arthroscopies, upper limb arthroplasties including elbow, wrist and finger joints, percutaneous and minimal invasive surgeries, super microsurgeries, and limb deformity correction with advanced technology application.
Clinical Service
The whole clinical team is composed of multidisciplinary professionals including surgeons, dedicated nurses, occupational therapists and physiotherapists. The urge for resource optimization and expertize enhancement catalyzed the formation of the cluster hand service within the New Territories East Cluster (NTEC) of the Hospital Authority of Hong Kong in 2002. Since then, there had been close collaboration among the hand surgeons and therapists in the Prince of Wales Hospital (PWH), the Alice Ho Miu Ling Nethersole Hospital (AHNH) as well as the North District Hospital (NDH), as exemplified by sharing of operating facilities and the launching of the NTEC Cluster Replantation Team Service in June 2002, the first of its kind in Hong Kong. In 2009, the hand surgery services in PWH and AHNH were further aligned and administered under a single cluster hand team concept as led by Dr. PC Ho, consultant and director of the cluster hand service. The current surgical team composed of two associate consultants, one resident specialist, two to three trainees, with Professor LK Hung being the advisor. The annual admission is around 800 cases, with more than 530 operations (emergency and elective) performed in PWH and about 450 elective cases operated at AHNH each year.
Besides general orthopaedic services, the Hand Team runs two special clinics in PWH: the Special Hand Clinic which takes care of patients with complicated hand and wrist problems requiring intensive monitoring and tailor made rehabilitation, and the CULA clinic which takes care of children with congenital differences in the hand and upper limb as well as those complicated pediatric hand and upper limb injuries. Both clinics are attended by dedicated therapists to enhance communication and fine tuning of the rehabilitation protocol to meet the special need and progress of individual patient. With similar concepts, a HARP (Hand Ambulatory Rehabilitation Program) clinic was established in AHNH since March 2010 by Associate consultant Dr. Sally HS Cheng. The subsequent AHNH hand service was led by Dr Clara Wong and Esther Chow, and currently SC Koo who is now Consultant in charge of hand service in AHNH. Supported by Pre-Operative Anaesthetic Clinic (POAC) service, most of the hand cases (including infants and children) operated in AHNH under general anaesthesia can be discharged on the same day of admission. This service later expanded to PWH as well.
The scope of service includes managing patients of all ages suffering from hand and wrist bony and soft tissue injuries, brachial plexus injuries and tumours, problematic wounds in upper and lower limbs, amputations, infection, tumours of upper limb, tendinopathies, entrapment neuropathies, post-traumatic, inflammatory and degenerative arthritis and disorders of the elbow, wrist and hand, tetraplegic, paralytic and spastic upper limb functional reconstruction, post-burn reconstruction and congenital differences of upper limb. The scope of expertise includes microsurgical repair of limbs, digits and fingertips, various types of local, distant and free flaps in wound coverage and functional reconstructions, nerve repair and brachial plexus reconstructions and joint replacement in small joints of the upper limb. Around 20 to 30 replantation cases are performed by the cluster replantation service team annually involving surgeons of PWH, NDH and AHNH. This service was awarded as Outstanding team in Hospital Authority in 2019. Major emphasis and intensive effort had been put on the advancement and the extended clinical application of arthroscopy and minimal invasive surgery in the wrist and hand, and lately in the elbow joint. The evolving concept and sophistication in skill enabled most if not all articular problems of the wrist to be managed arthroscopically. More than 150 wrist, elbow and finger joints arthroscopies and more than 100 endoscopic carpal tunnel release are performed by the cluster hand team each year.
Dr. Sally HS Cheng extended the application of wound care and microsurgical technique in management of complex lower limb, especially foot and ankle wounds secondary to trauma and diabetic conditions. Led by Professor LK Hung she also took care of paralytic patients wound care notably pressure injury surgeries at the former Foot & Ankle, Infection and Rehabilitation (FAIR) team. Currently she is in private practice.
Dr. Clara WY Wong has made considerable breakthroughs and established a solid foundation in elbow surgery especially on arthroscopic surgery and arthroplasty, and has streamlined the rehabilitation and research protocol. Currently she is Clinical Professorial Consultant of the Chinese University of Hong Kong.
Dr. Esther CS Chow succeeded the noble tradition and continued to develop a more mature service and registry for congenital upper limb differences. Certainly these are other important foci that our team is committed to develop and advance. Currently she is the Consultant and head of hand team in United Christian’s Hospital.
Dr. Michael CK Mak, currently consultant in PWH Hand team and Trauma A team, ventured into the field of navigation and computer aided surgeries in upper limb deformity correction secondary to trauma or congenital and pediatric conditions, and even apply to tiny scaphoid malunion. He also developed super-microsurgery in excelling lymphatic anastomosis for both upper and lower limb lymphoedema conditions, in close collaboration with Dr. Jeannette Ting, Assistant Professor of Department of Plastic and Reconstructive Aesthetic Surgery, and arthroscopic elbow ligament reconstruction. He also takes care of trauma service, established trauma A team, works closely with Foot & Ankle team and contributing in all types of trauma services and playing an important role in training and nurturing trainees and young specialists.
Dr. PC Ho, after leading the team for 14 years and became the Chief of Service of the whole Orthopaedic department, continues to serve and extended his role to support the hand service of Kwong Wah Hospital since Nov 2023 and subsequently Palmela Youde Nethersole Eastern Hospital since July 2025, while keeping his supervising role in PWH hand team.
Dr. WL Tse, the current head of hand team, taking up the administrative role and training of young specialists. In 2025, the team is composed of 3 consultants: Dr WL Tse and Dr. Michael Mak, with Dr. PC Ho as advisor, and 3 specialists: Dr. Leo TC Chau, Dr. Michelle KL Li and Moya KH Tsui.
Research
Clinical research has been an integral part of the team development and core value since its establishment. Extensive output has been produced by Professor PC Leung in microsurgeries, including the report of the first hand replantation in Hong Kong in 1975, and numerous publications in the application of toe to hand transfer and burn hand reconstructions. Publications and researches in congenital differences included epidemiology, classification and management strategy on extra-thumb, innovative surgeries such as free hemi-metatarsal bone graft for hypoplastic thumb reconstruction, pulp island flap augmentation of extra-thumb, syndactyly correction without need for skin graft, preservation of a 5 fingers hand in Apert’s syndrome etc. Nerve surgeries included outcome study on various minimal invasive carpal tunnel releases, medial epicondylectomy for cubital tunnel syndrome, as well as an anatomical study in musculocutaneous nerve and application in functional muscle transfer, to name a few.
Publications on wrist surgery included wrist arthroscopy under portal site local anaesthesia, novel technique of arthroscopic resection of volar wrist ganglion, new classification system for scaphoid fractures, percutaneous scaphoid screw fixation and management of ulnar wrist pain following distal radius fractures. A significant breakthrough was the arthroscopic bone grafting for scaphoid nonunion developed by Dr. PC Ho and Professor LK Hung in 1997 and is now being popularized internationally. Other innovations and original ideas included arthroscopic assisted TFCC reconstruction with tendon graft, arthroscopic carpectomy and limited carpal fusion, as well as arthroscopic osteochondral bone grafting for cartilage defects. Our outstanding research works won multiple awards at major meetings, including the Hodgson Award for 4 times and the Arthur Yau Award for 3 times at the Annual Congresses of the Hong Kong Orthopaedic Association between 1995 and 2010. Team members also won the Best Paper Awards at the Annual Congresses of the Hong Kong Society for Surgery of the Hand 8 times between 1998 and 2009. In 2012, Dr. PC Ho was granted with the Terry Whipple Prize at the Congress of the Federation of European Societies for Surgery of the Hand in Antwerp, Belgium to honor his achievement in wrist arthroscopic surgery.
On the collaboration side, we worked with the stem cell research team under direction of Professor Li Gang on the possibility of delivering mesenchymal stem cells for wrist cartilage regeneration in minimally invasive surgical manner. Besides, there were extensive input from the Department of Diagnostic Radiology and Organ Imaging, leaded by Professor James Griffith, Alex Ng and Ryan Lee, enabling valuable study such as assessment of the blood flow of scaphoid nonunion with MRI and the correlation of MRI with arthroscopic findings, the invention of traction MRI on wrist imaging, imaging of carpal tunnel and median nerve in relation to surgery… etc. More clinical –radiological studies will be conducted through our close collaboration and eagerness to explore and discover from different perspectives.
Teaching and Training
Our team provides undergraduate teaching for medical students of the Chinese University of Hong Kong in Year 1, 4 and 6 and also trainees from various orthopaedic and surgical units over Hong Kong. We established the first basic microsurgery training course in Hong Kong in 1986 with annual intake of 20 surgeons, followed by the advanced course in 1993. With support from CUHK we have been conducting two popular courses every year over the past 2 decades: First, the Microsurgical course provides microsurgical training for trainees and specialists of different disciplines, local and overseas, including orthopaedics, general surgery, ENT and plastic surgery etc. and second, the Wrist arthroscopy workshop.
Since 2000, with the support of HKSSH and the Orthopaedic Learning Center, we have conducted numerous cadaveric workshops led by world experts on elbow arthroscopy, upper limb arthroplasty on elbow, wrist and hand, scaphoid fracture fixation, flap dissection and tendon repair etc.
The most well-known workshop is the Annual Wrist Arthroscopy Workshop founded in 1997 by Professor LK Hung as part of an advanced training course for orthopaedic surgeons from the Mainland China. Dr. PC Ho succeeded the directorship in 2008 and transformed the event into an international one with teaching faculty and participants from worldwide. Over the past 5 years, participant number raised from 58 to over 120, and participating countries or areas from 16 to 22, covering most of the Asia-Pacific countries and many in Europe and America. To date over 1,000 surgeons worldwide have benefitted from the workshops and many have commenced wrist arthroscopic surgery in their clinical practices. Our training program had drawn numerous hand surgeons from all over the world from Asian-Pacific countries and Europe and the United States to become our clinical fellows for varied duration. Our reputation also gained the visit of a number of Bunnell’s Travelling Fellows of the American Society for Surgery of the Hand since 1992. In addition, we have inspired many centers in the region including Taiwan, Singapore, Wenzhou, Shanghai, Beijing and lately in Ningbo, Wuxi Mainland China to set up wrist arthroscopy courses on a regular basis. Since 2009, we have been playing instrumental roles in the wrist arthroscopy workshops in conjunction with the European Wrist Arthroscopy Society (EWAS, now named International Wrist Arthroscopy Society IWAS) twice every year at both Lukang, Taiwan and Strasbourg, France. The establishment of these international interactions and fraternity has certainly enhanced the transfer of knowledge and skill, exchange of new ideas and concepts, research collaboration, and promotion of arthroscopic surgery of the hand and wrist in a worldwide scene.
In 2015, a group of Hong Kong surgeons lead by Dr. PC Ho, has founded the Asian Pacific Wrist Association (APWA). This association began with surgeons or “wrist lovers” of Aisa Pacific region but rapidly expands to more worldwide influence. A travelling fellowship was established in 2017 which supports 3 surgeons every year to play 4 weeks visit to at least 4 accredited wrist centers in Asian pacific region to learn from the masters and establish friendship and fellowship.
Highlights
 Arthroscopic Reconstructive Wrist Surgery
 Congenital Hand Surgery
 Small Joint Replacement
 Microsurgery
Finale
Hand surgery represents one of the most challenging fields in surgery: fascinating surgical technique; precise handling of bone, joint and soft tissue; Her potential for future development becomes unlimited with the application of different amours including microsurgery, arthroscopy, arthroplasty, navigation, 3D planning and Patient Specific Instrument and even robotic surgery. I believe she will continue to flourish in keeping place with any new technological development and basic science research.
In the Future, our team will continue to face all the new challenges and continue to strive for the best in clinical service, research, training and teaching in the field of hand surgery.
 Team Gathering with our Singapore Fellow, 2012
 1st Wrist arthroscopy course in 1997  1st International wrist arthroscopy workshop in 2008
 Prof. Berger visit in 1997 |
