Healing hands

U-M hand surgeon helps patients and colleagues abroad

“I really enjoy the making of a thumb,” says University of Michigan hand surgeon, Dr. Kevin Chung. “It’s a challenge that requires both skill and creativity;” a combination of factors that, for him, hits the surgical sweet spot. This specialized interest is one of the many reasons why his practice has made U-M one of the nation’s leading destinations for hand surgeries.

Widely regarded as one of the top hand- and upper-extremity surgeons in the world, Chung performs a variety of reconstructive procedures for patients with rheumatoid arthritis, congenital hand problems, spinal cord injuries, nerve injuries, and complex fractures. But it’s his research and teaching in the field that are making an impact on the lives of patients across the globe.

Since 2004, Chung has volunteered with an organization called Interplast, which sends teams of medical volunteers abroad to provide free reconstructive surgery to the poor. He has performed surgeries and taught pediatric hand surgery techniques to local surgeons in Honduras, Peru, Cambodia, Ghana and Vietnam.

“Pediatric hand care is critical in developing countries, which have little expertise in surgical techniques to repair childhood injuries and congenital defects,” said Chung, an Associate Director of the University of Michigan medical school’s Global Reach program. “It’s heartbreaking to see young children with fixable conditions who don’t have access to proper treatments.”

On Interplast trips, Chung works with the same challenges that local physicians face every day – inadequate infrastructure, limited equipment, adult-sized instruments for pint-sized patients. It’s the only way to ensure that the procedures can continue even after the Interplast teams leave.

“One of these team trips can cost $100,000,” Chung said. “A salary for a surgeon in Vietnam is probably $200-$300 a month. If you train one of those surgeons, pay him or her to do selected operations and make taking care of the poor part of his or her practice, that $100,000 goes a long way.”

Likewise, a relatively simple procedure can make a big difference. Chung has made three trips to Vietnam, where he’s been invited to teach surgeons at the top children’s hospital in the country. On one Thanksgiving Day trip three years ago, he taught colleagues a reconstructive technique called a groin flap, which uses the thin, flexible skin of the groin to temporarily protect and provide blood flow to an open wound on the hand.

“That one simple procedure allowed surgeons who learned about it to fundamentally change how they take care of these patients,” he said. “I went back three months later to see whether this technique had helped them, and there were a lot of children who’d had this groin flap procedure already.”

Born in Taiwan, Chung moved to Singapore at age eight and lived there until he started high school. “My parents were both schoolteachers, and they believed that the US education system offered kids more opportunities to be creative and get a broader education.” When he was 16, his parents gave up their teaching careers and the family relocated to Atlanta, GA, where he and his younger brother continued their education.

Chung went on to attend college and medical school at Emory University. “I always knew I wanted to be a doctor, from the time I was quite young. My grandfather was a family physician in Malaysia and my grandmother encouraged all of us – her children and grandchildren – to follow in his footsteps. She believed medicine to be among the noblest professions. Her opinion had a lot of influence because, in my extended family, there are more than 30 physicians, including me and my brother who is a general surgeon in Louisiana!”

During medical school, Chung was strongly encouraged to pursue a surgical specialty. “I really enjoyed both my medicine and surgery rotations and would likely have been happy with either choice. But surgery utilized my cognitive and tactile skills and, as a result, my medical school professors thought I had great potential as a surgeon. I’m grateful to them for giving me that push.”

Hand surgery offered a unique mix of challenges that Chung found especially compelling. “Hand surgery requires good surgical judgment and the ability to manage complex surgical scenarios. It’s also highly creative, which I enjoy a lot.”

Chung joined the Plastic Surgery Section at the University of Michigan in 1995 after completing fellowships in microvascular surgery, plastic surgery, and hand surgery. He was a Robert Wood Johnson Clinical Scholar when he earned a Masters degree in statistics and research design from the University of Michigan’s School of Public Health.

Building on the prestige of his Michigan program, Chung recently launched a new Hand Fellowship to provide highly-specialized training to one plastic or orthopedic surgery fellow each year. “We want to train the best hand surgeons in the world –people who will represent our world-class institution. The program is designed to prepare leaders in the field of hand surgery.” Qualified applicants from U-M are strongly encouraged to apply, but will compete with residents from across the country for the year-long appointment.

Among his many research projects, Chung is the principal investigator for a comprehensive, multicenter clinical study on the rheumatoid hand, funded by a National Institutes of Health R01 grant. The five-year study aims to determine whether surgery or other medical therapies work best in treating rheumatoid arthritis.

“I don’t really consider myself a researcher, because I am always a surgeon first,” he said. “I choose research projects that are designed to make me a better surgeon, and to help my students become better physicians. Everything we do is always about improving patient care, so our research goals, ultimately, are to create better surgical techniques or identify more effective treatments for patients.”

Chung has also received three additional NIH grants to study the treatment of musculoskeletal conditions. Most notably, he was awarded a K24 Mid-Career Grant from NIH to serve as a mentor for researchers in this field of study.

He was recently awarded the first-ever Andrew J. Weiland Medal by the American Foundation for Surgery of the Hand, which honors a hand surgeon who has contributed a body of research that has advanced the science and practice of hand surgery. The American Foundation for Surgery of the Hand is the educational arm of the American Society for Surgery of Hand, which is the largest hand surgery organization in the world.

“I do not know how long my life will be, nor how long my career will be; but as long as I’m doing it, I want to do it well. It’s a real honor that my fellow hand surgeons have found value in my work to date.”

Out of all his accomplishments, though, Chung says he’s most proud of being at the University of Michigan. “I am so grateful for the opportunity to work here and for all my colleagues and trainees who have played, and continue to play, a major role in my development as a surgeon and teacher. It is because of that support that my team and I have been able to create the top hand surgery program in the country.”

Chung is also the Assistant Dean for Instructional Faculty who oversees faculty reviews and promotional processes. When he’s not a doctor, he enjoys playing tennis and taking long walks with his nine-year-old son.

By Amy Bunch. This article was originally published in the December 8, 2009 edition of the  U-M Department of Surgery‘s In the Loupes newsletter.