. : Mr , how to forward to you?

TOKEN ENTRY: I am before a whole surgeon, a general surgeon, but I grew within the organization of the and thus I have a leaning fort for traumatology. I was with the head of the department of surgery of the hospital of Davos during more than 20 years. I stopped approximately 7 years ago because one asked me to deal with the International which is the branch of teaching of foundation . It is what I did during 6 years and now I am chairman of Foundation .

 

. : How does one become chair ?

TOKEN ENTRY: While being elected! On the chronological level, I am a representative of the second generation of the but I am the last of those which made party of the group since its beginnings.

. : Was the of the beginnings different?

TOKEN ENTRY: Certainly. It was then, towards end of the year 50, about a group of Swiss surgeons csotcina.comedists or general practitioners who were not satisfied of the processing of the fractures. They decided whereas new methods of processing of the fractures were to be focusings. They did not want to be satisfied any more to obtain an osseous consolidation, but they wanted also a restoration complete of the function. Thus they understood that they needed instruments to achieve their goals. And it is thus as all started and much things were carried out with this group. But today the Foundation has multiple activities and multiple ramifications in an csotcina.comedic world marked by the competition.

 

. : But don't you think that the initial objectives of the group were largely achieved?

TOKEN ENTRY: It is probably true for certain countries where the operative techniques reached very a top-level of sophistication, but it still remains of vast areas of the sphere where average the techniques are limited, where it is necessary to have more modest objectives and where the implementation of the basic principles of the group still takes all its direction.

. : The was in the beginning a innovating organization and now it rather seems to be directed towards the formation…

TOKEN ENTRY: But one can be innovating as regards formation and I think that we make much to be heading in teaching. It is true that the principles of the were so much disseminated and implemented that one could say that we achieved all our goals and to remain about it there. However it is surprising to see the number innovations to seem for example all the techniques of minicomputer-access. The increasingly severe traumatisms of the soft parties make essential this approach which not only tends to repair the fracture but also to adhere to the soft parties as well as possible. The surgery computer-assisted is another example of innovation which opens with the speciality a vast field of application.

. : But can one say that these innovations come from work of the ?

TOKEN ENTRY: The is very implied in all these technologically advanced sectors. However I understand your question. We travelled by the landing gear walks from there in certain fields as for example the locked which was promoted by French. We probably believed that the sophistication of our techniques would exempt methods like the locked to us. But we returned in the race and we particularly develop the techniques initially minimal and of indirect reduction of the fractures. Moreover our Institute of Development is very active.

. : In which field?

TOKEN ENTRY: In the field of the biology of the consolidation. We are in close contact with many research teams on the acceleration of the osseous consolidation. However these techniques based on the genetic engineering or the development of new molecules will not abolish the need for the hardware of osteosynthesis because there will need always to stabilize the fractures. We are also implied in the development of biodegradable materials.

. : If the consolidation were very accelerated, it would be enough to a plaster…

TOKEN ENTRY: Yes and not. If we had given up the plaster it is to be able to mobilize the hinges immediately. I doubt that biology reduces the times of consolidation enormously. Apart from the functional benefit, osteosynthesis makes it possible to stabilize the fracture and also makes it possible to decrease the pains!

. : How the teaching of the exchange rates of the is organized…

TOKEN ENTRY: As you can note it, we have a great conference center in Davos, which receives all the participants. Moreover we organize run in the whole world. There are thus two possibilities of profiting from the exchange rates of the . For example, for the exchange rate of this week we have participants of 80 different countries. What is remarkable, it is that only a third party comes before very being levelled. The others are rather interested by the possibility of meeting the teachers. We have here all the academics who publish in the prestigious csotcina.comedic reviews and the participants are charmed to meet them to discuss with them to be even made take in photograph in their company. In addition we have the central head office of the which understands our offices and the Research institute and Development. There are thus many reasons to come to Davos and I must say that for the it is more economic than to send a team of teaching in each country. That known as we move regularly. But here the possibilities of practical works are optimal. The hardware which is used for the workshops is of great quality; in fact it is exactly that which exists in the modern . The bones of demonstrations are manufactured by our services, without profit, and show mechanical characteristics close to the human bone in order to give to the participants the conditions of drive closest to the private clinic.

. : Did you plan to work on corpses?

TOKEN ENTRY: You know at the beginning, in 1960, we worked on human bone but today we need 250 007 bones and with human parts that would pose ethical problems and infectious major. For a teaching of this span, it is impossible. However, the dry bone is not the ideal educational materials. In certain countries one can still make small seminars of surgery where one is exerted on corpse. That makes it possible to teach in a realistic way the surgical accesses. It is well when one can do it but as a whole that becomes increasingly difficult. This is why we are interested more and more in the teaching possibilities of virtual reality. We work on these projects with technical Institutes in Zurich and in France.

. : Is there a kind of organized by the ?

TOKEN ENTRY: We propose short formations of 2 or nths and we have approximately 220 posts a year. The “” are distributed on a hundred “private clinics”. Those for the majority are located in Europe but also in North America of the South and Asia in order to overcome the problems of language. The reception facilities do all of traumatology but with sometimes specializations like the rachis or the maxillofacial one. Useless to tell you that these posts are very appreciated and very coveted.

. : How does one make to postulate?

TOKEN ENTRY: We do not have large files to fill. You can directly make besides your request by the means of Internet site of the . There is a restricted committee of the International which chooses among the candidates who, he should be said, are increasingly more numerous than the posts. We try to adhere to a geographical quota and to be most equitable possible in this choice. Thus you see that the as regards indoctrination acts in a direct way with the exchange rates and the training courses but there is also an indirect teaching share which is done through the publications, of Internet and new technologies.

. : How the finds its resources financial?

TOKEN ENTRY: Foundation is a medical scientific institution. It has a company called Synthes which does not aim to make profits. has agreements with three manufacturers who them, have the exclusiveness in the products developped at the point by the and which is manufactured under the Synthes label. These three manufacturers are with in Switzerland, with in Switzerland and the USA. The profits generated by the exploitation of these Synthes licenses are transferred with the . Thus we can finance all this teaching and all this search.

. : That leads us to question us on the future of the …

TOKEN ENTRY: We are implied in fundamental research and especially in research programs implemented in order to always keep a foot in clinical reality. I thus think that there are many fields likely to be the subject of field of development such as for example the biodegradable implants or the fixing of implant in the osteoporotic bone. The ageing of the populations has great effects on the saving in health and it is a field where there is real progress to make. And of course, there will be always the educational programs.

. : At which you were formed?

TOKEN ENTRY: At Prof which is one of the pioneers of foundation . I began my boarding school in 1958 in where he exerted. Later I followed it to Basle. I became Instructor at the University of Basle and I was detached from this university in 1971 to teach in Davos. Now I do not exert any more.

. : Do you have the impression today great difference in the processing of the leg fractures compared to your time?

TOKEN ENTRY: To tell the truth not! My formation of traumatology at which was a general surgeon, as my two years of plastic surgeon had sensitized me much with the respect of the soft parties. In the surgical team there was a true symbiosis between the mechanical and comprehension of the csotcina.comedist and the more biological approach of the general surgeon.

. : For example, how do you discuss the largely open fractures?

TOKEN ENTRY: We fixed them with screwed plates and if we could not close them we let us leave them open. We rather had as a whole good performances. I wrote a work besides on the subject. Today everyone is of agreement on the principle which the stabilization of an open fracture is the best means of preventing the infection but, however, by means of an external fixer. One tries remotely to be held of the chamber that it is open besides or closed because in the very fractures the vascularization of the soft parties is compromised. It is what led to the development of the minimal accesses. Incontestably external fixing made well progress the assumption of responsibility of the high-energy traumas. My results with the plates in the open fractures 30 years ago were not bad but they probably were not lesions as serious as those today.

. : What remains conventional opposition between nail and plate?

TOKEN ENTRY: It is true that there were clans “of ” and “platers”. The hard core of the was described as “plater” integrist but this reputation was excessive. When it forwarded a good central-medullary indication of we put a nail, but when there was possibility of choosing one or the other procedure of osteosynthesis we always preferred the plate for the good reason which we unceasingly develop of new models of plates and which we had needs for clinical results. However, I made a worldwide multicenter study 8 years ago on the preferences of the csotcina.comedists and it appeared that as a whole the plate was used than the nail and this for various reasons. One of the reasons it is that everyone cannot have imagery in the . Some think that osteosynthesis by plate is more difficult than that by . It is not my opinion but I was educated with the plate.

. : Which are the reproaches which one generally makes with the ?

TOKEN ENTRY: I believe that one often reproaches us our “stability” in the pejorative direction of the term. This is why during my Chair I encourage the hyperdynamic behaviors. And I can tell you that we are surrounded particularly dynamic young men.