Les Meilleurs doctors pour votre Réparation de carte bancaire - TOP 18 des médecins

Le professeur Dr Gürsel Saka est un spécialiste en orthopédie et traumatologie qui a suivi une formation médicale à l'Université technique de Karadeniz et une formation spécialisée à l'Université des sciences de la santé, à l'hôpital de formation et de recherche Dr Lütfi Kırdar Kartal. Il a réalisé avec succès des interventions chirurgicales dans les domaines de la chirurgie de la colonne vertébrale, de la chirurgie traumatologique, de l'arthroplastie et de la chirurgie du bassin-acétabulum. Il s'occupe actuellement des patients du service d'orthopédie et de traumatologie intercontinentale de l'hôpital Hisar.

Le Dr Selman Dogan est un chirurgien orthopédiste réputé spécialisé dans l'arthroplastie de la hanche et de l'épaule, la traumatologie sportive, la chirurgie traumatologique des membres inférieurs et supérieurs, la chirurgie de la colonne vertébrale et les blessures des ligaments et des tendons du genou. Il est titulaire d'un baccalauréat de la faculté de médecine Cerrahpasa de l'université d'Istanbul et a effectué des résidences à l'hôpital de formation et de recherche Umraniye d'Istanbul et à l'hôpital de formation et de recherche Sanliurfa Mehmet Akif Inan.

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• Société turque d'orthopédie et de traumatologie, branche de chirurgie de la main

• Société turque d'orthopédie et de traumatologie, branche de chirurgie de la colonne vertébrale

• Société turque d'orthopédie et de traumatologie, branche des blessures sportives

• Société turque d'orthopédie et de traumatologie, branche d'orthopédie pédiatrique

Assoc. Le professeur Erkam KÖMÜRCÜ, MD est professeur agrégé d'orthopédie et de traumatologie, avec une expérience dans l'enseignement et les tâches administratives. Il est titulaire d'un certificat BOARD de la Société turque d'orthopédie et de traumatologie – Conseil de formation (TOTEK) de 2010 et d'un titre de professeur agrégé d'avril 2015. Le Dr Kömürcü possède une vaste expérience en orthopédie et traumatologie, en blessures de la main et des membres supérieurs, en fractures et en luxations. du membre inférieur, évaluation radiologique des tumeurs musculo-squelettiques, des dysplasies interventionnelles de la hanche, des tumeurs musculo-squelettiques bénignes et malignes, des fractures vertébrales, des lombalgies et des fractures du bassin.

Experience

2022

Private Nisa Hospital

2022 - 2022

American Hip Institute Chicago, USA

2018 - 2022

Health Sciences University Bağcılar Training and Research Hospital

2016 - 2018

Erzincan Mengücek Gazi Training and Research Hospital

2015 - 2015

Helios Endo Clinic, Hamburg, Germany

2015 - 2015

UPENN Sports Medicine Center, Philadelphia, USA

Education

2021

ISTANBUL UNIVERSITY ISTANBUL FACULTY OF MEDICINE, Department of Sports Medicine, Football Medicine

2016

Health Sciences University, Department of Orthopedics and Traumatology

2009

ISTANBUL UNIVERSITY, FACULTY OF MEDICINE

Département de chirurgie orthopédique, Centre médical Sourasky de Tel-Aviv.

Spécialités reconnues:

Chirurgie orthopédique.

Formation complémentaire:

Orthopédie infantile, département d'orthopédie pédiatrique, hôpital pour enfants "Dana-Dwek", Sourasky Aviv via Telnet Medical Centre, Israël.

Communication orthopédique infantile. Département de chirurgie orthopédique, Sick Children's Hospital, Toronto, Ontario, Canada.

Directions de travail:

Maladies du nouveau-né et de l'enfant.

Traumatismes et fractures de l'enfant.

Maladies neuromusculaires causées par l'infirmité motrice cérébrale.

Expérience clinique:

Chirurgien orthopédique pédiatrique en chef, Hôpital pour enfants Dana-Dwek, Tel Aviv Israël.

Publications:

5 publications évaluées par des pairs.

Publications récentes sur PubMed.

Membre de sociétés professionnelles:

American Academy of SR

American Society for Paediatric Orthopaedics.

Domaines d'intérêt particuliers:

Désordres de la hanche chez les nouveau-nés et les enfants.

Les blessures et les fractures chez l'enfant.

Les maladies des muscles nerveux comme l'infirmité motrice cérébrale.

Déchiffrer les résultats des laboratoires de marche informatisés.

• Éducation
• Faculté de médecine : Faculté de médecine, Technion, Haïfa.
• École de formation continue, Faculté de médecine, Université de Tel-Aviv.
•  

Le Dr Aviram Gold est un chirurgien orthopédique très expérimenté, spécialiste des prothèses de la hanche et du genou, avec plus de 20 ans d'expérience. Il est titulaire d'un doctorat en médecine de l'Université hébraïque de Jérusalem, de l'École de médecine Hadassah et d'une maîtrise en administration de la santé de l'Université Ben-Gourion du Néguev, École de gestion, Département de gestion des systèmes de santé. Il est certifié par le conseil israélien de chirurgie orthopédique et générale, certifié en médecine aéronautique et a suivi le cours avancé de l'AO : Advances in fracture treatment, Leeds et Advanced Trauma Life Support Instructor course. Il propose des traitements pour toute une série d'affections musculo-squelettiques, les interventions les plus courantes étant la réparation du tendon de l'épaule (coiffe de rotation), l'arthroscopie du genou, l'arthrodèse de la cheville, l'arthroplastie totale du genou B/L, l'arthroplastie totale de la hanche B/L, la chirurgie de resurfaçage de la hanche, la reconstruction du ligament croisé antérieur (LCA), la réparation du ménisque, la libération du canal carpien et l'arthroscopie de l'épaule. Heures d'ouverture : Du lundi au samedi, de 8 heures à 16 heures.

• 2017;Yakın Doğu Üniversite Hastanesi
• 2015 - 2017; Aksaz Asker Hastanesi
• 2010 - 2015; GATA Haydarpaşa Eğitim Hastanesi Ankara
• 2001 - 2007; GATA Tıp Fakültesi Ankara

Over 60 articles published in International and National Peer Reviewed Scientific Journals

Over 50 papers-posters presented in International and National Meetings-Congresses

Articles published in international peer reviewed journals (SCI & SCI exp.):

1. Aydin A,Wollstein G, Price LL, Fujimoto JG, Schuman JS. Optical coherence tomography assessment of retinal nerve fiber layer thickness changes after glaucoma surgery. Ophthalmology. 2003:110(8);1506-1511.
2. Aydin A, Wollstein G, Price LL, Schuman JS. Evaluating pulsatile ocular blood flow analysis in normal and treated glaucomatous eyes. Am J Ophthalmol. 2003;136(3):448-453.
3. Schuman JS, Wollstein G, Farra T, Hertzmark E, Aydin A,Fujimoto JG, Paunescu LA. Comparison of optic nerve head measurements obtained by optical coherence tomography and confocal scanning laser ophthalmoscopy. Am J Ophthalmol  2003:135;504-512.
4. Wollstein G, Schuman JS, Price LL, Aydin  A,Beaton BA, Stark PC, Fujimoto JG, Ishikawa H. Optical coherence tomography (OCT) macular and peripapillary retinal nerve fiber layer measurements and automated visual fields.  Am J Ophthalmol. 2004;138(2):218-225.
5. Wollstein G, Schuman JS, Price LL, Aydin A,Stark PC, Hertzmark E, Lai E, Ishikawa H, Mattox C, Fujimoto JG, Paunescu LA. Optical coherence tomography longitudinal evaluation of retinal nerve fiber layer thickness in glaucoma. Arch Ophthalmol. 2005;123:464-470.
6. Ersanli D, Unal M, Aydin A,Gulecek O, Kalemoglu M. Results of pars plana vitrectomy in closed-globe injuries. Ophthalmic Surg Lasers Imaging. 2005;36:182-186 .
7. Aydin A,Akin T, Bilge AH. Management of persistent glaucoma secondary to depot methylprednisolone. Ophthalmic Surg Lasers Imaging. 2007;38:399-401.
8. Ersanli D, Top C, Oncul O, Aydin A,Terekeci H. Relationship between serum soluble E-selectin levels and development of diabetic retinopathy in patients with type 2 diabetes. Scand J Clin Lab Invest. 2007 ;67 :474-479.
9. Akin T, Aykan U, Karadayı K, Aydin A, Yildiz TF, Bilge AH. Capsulorhexis in white cataract using a green-light endoillumination probe. Ophthalmic Surg Lasers Imaging 2007 ;38 :520-522.
10. Unal M, Aydin A,Sonmez M, Ayata A, Ersanli D. Validation of the ocular trauma score for intraocular foreign bodies in deadly weapon-related open-globe injuries. Ophthalmic Surg Lasers Imaging 2008 ;39:121-124.
11. Aydin A,Karadayi K, Aykan U, Can G, Colakoglu K, Bilge AH. [Effectiveness of topical ciclosporin A treatment after excision of primary pterygium and limbal conjunctival autograft.]  J Fr Ophtalmol 2008;31 :699-704.
12. Dogru S, Gungor A, Kucukodaci Z, Aydin A,Senol MG, Karabudak O, Cincik H, Gunes M, Salihoglu M. Lipoid proteinosis-report of three cases and brief review of the literature. The American Journal of Case Report, 2008;9:346-350.
13. Aydin A,Ayata A, Sabahyildizi M, Ersanli D. [Poland-Möbius syndrome associated with lacrimal punctal and canalicular agenesis.] J Fr Ophtalmol 2010;33:119.e1-e5.
14. Aydin A,Velioglu M, Ersanli D. [Orbital varix presenting with enophthalmos. A case report ]. J Fr Ophtalmol 2010;33: 344.e1-344.e5.
15. Aydin A, Cakir A, Ersanli D. Isolated extraocular muscle involvement as the ophthalmic manifestation of leukemia- another explanation. Clin Experiment Ophthalmol. 2010;38(6):651.
16. Aydin A,Cakir A, Sayan O, Haholu A, Velioglu M, Ersanli D. Intraocular pressure elevation in isolated extraocular muscle infiltration by leukaemia. Clin Experiment Ophthalmol 2011 Apr;39(3):283-5.
17. Aydin A, Aksoy Y, Unal MH, Ersanli D. [Necrotizing scleritis after pterygium surgery using mitomycyn C.] J Fr Ophtalmol 2012;Jan;35(1):74-75.
18. Aydin A,Sabahyildizi M, Bilge AH. [Management of extruded haptic of an anterior chamber lens.] J Fr Ophtalmol 2012 Apr;35(4):315.
19. Aydin A,Cakir A, Unal MH, Ersanli D. Central serous retinal detachment following glaucoma filtration surgery. J Fr Ophtalmol 2012;35:529.e1-529.e5.
20. Aydin A, Sabahyildizi, Kocak I. Auto-refractometer may assist in discovering asymptomatic iridociliary cysts. J Fr Ophtalmol 2014;37(5);e.71-e.72.
21. 21. Kocak I, Aydin A, Kaya F, Koc H.Comparison of transepithelial corneal collagen crosslinking with epithelium-off crosslinking in progressive keratoconus J Fr Ophtalmol 2014;37(5): 371-376
22. Kocak I, Kocak F, Teker B, Aydin A, Kaya F, Baybora H. Evaluation of bacterial contamination rate of the anterior chamber during phacoemulsification surgery using an automated microbial detection system. Int J Ophthalmol 2014;7(4):686-688
23. Cakir A, Duzgun E, Demir S, Aydin A. Jerky see-saw nystagmus with internuclear ophthalmoplegia as the presenting finding in systemic lupus erythematosus. J Fr Ophtalmol 2014;37(10):e157-159.
24. A4. Kocak I, Aydin A, Sahbaz I, Kaya F, Baybora H. The management of corneal melt occurring after collagen cross-linking for keratoconus. J Fr Ophtalmol 2015;38(1):e11-13.
25. Aydin A,Kocak I, Aykan U, Can G, Sabahyildizi M, Ersanli D. The influence of the learning effect on automated perimetry in Turkish people. J Fr Ophtalmol 2015;38(7):628-632.
26. Kaya F, Kocak I, Aydin A, Baybora H, Karabela Y. Comparison of different formulas for intraocular lens power calculation using a new optical biometer. J Fr Ophtalmol 2015; Jul 20. pii: S0181-5512(15)00223-5. doi: 10.1016/j.jfo.2015.03.006.
27. Kocak I, Aydin A, Kaya F, Baybora H, Bozkurt S.Efficacy of radial keratotomy in the optical rehabilitation of mild to moderate keratoconus cases. Int Eye Scı 2015;15:572-576
28. Porter LF, Galli GG, Williamson S, Selley J, Knight D, Elcioglu N, Aydin A, Elcioglu M, Venselaar H, Lund AH, Bonshek R, Black GC, Manson FD.  A role for repressive complexes and H3K9 di-methylation in PRDM5-associated brittle cornea syndrome. Hum Mol Genet 2015;24(23):6565-6579.
29. Kaya F, Kocak I, Aydin A, Baybora H, Koc H, Karabela Y. Effect of aflibercept on persistent macular edema secondary to central retinal vein occlusion. J Fr Ophtalmol. 2018 Nov;41(9):809-813.
30. Balci O, Tanriverdi C, Aydin A, Ozsutcu M, Gulkilik G, Kocabora MS. Evaluation of changes in retinal and choroidal thickness using spectral domain optical coherence tomography in unilateral non granulomatous acute anterior uveitis. J Fr Ophtalmol. 2019 Feb;42(2):138-145.
31. Cakir A, Erden B, Bolukbasi S, Aydin A, Yurttaser Ocak S, Maden G, Elcioglu MN. Comparison of the effect of ranibizumab and dexamethasone implant in diabetic macular edema with concurrent epiretinal membrane. J Fr Ophtalmol.2019 Sep;42(7):683-689.

Papers presented at international scientific meetings and published in the proceedings book:

1. Schuman JS, Wollstein G, Paunescu AL, Ishikawa H, Aydin A, Hertzmark E, Fujimoto JG, Mattox C. Optical Coherence Tomography longitudinal retinal nerve fiber layer thickness assessment. Presented at the International Congress of Eye Research (ISER), Geneva, Switzerland, Oct. 2002.
2. Aydin A, Wollstein G, Price LL, Schuman JS. Optical coherence tomography assessment of retinal nerve fiber layer thickness changes after glaucoma surgery.  Poster presentation at the American Academy of Ophthalmology (AAO) annual meeting, Orlando, FL, USA, Oct. 2002.
3. Wollstein G, Schuman JS, Price LL, Aydin A, Hertzmark E, Ishikawa H, Mattox C, Fujimoto JG, Paunescu AL. Evaluating longitudinal retinal nerve fiber layer thickness changes with Optical Coherence Tomography. Presented at the American Academy of Ophthalmology (AAO) annual meeting, Orlando, USA, Oct. 2002.
4. Wollstein G, Schuman JS, Hertzmark E, Aydin A. Optical Coherence Tomography findings predicting future visual field progression.  Presented at the American Glaucoma Society (AGS) annual meeting, San Francisco, CA, USA, March 2003.
5. Wollstein G, Schuman JS, Price LL, Aydin A, Hertzmark E, Ishikawa H, Mattox C, Paunescu AL, Fujimoto JG. Longitudinal Optical Coherence Tomography evaluation of retinal nerve fiber layer thickness in glaucoma patients. Presented at the 4thInternational Glaucoma Symposium (IGS), March 2003, Barcelona, Spain.
6. Wollstein G, Schuman JS, Price LL, Aydin A, Paunescu LA, Stark PC, Fujimoto JG, Ishikawa H. Relationship between optical coherence tomography (OCT) macular and peripapillary measurements and automated visual fields. Submitted for presentation at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting, May 7, 2003.
7. Aydin A, Karadayi K, Can G, Colakoglu K, Bilge AH. Efficacité du traitement topique de ciclosporine A après l’excision du ptérygion primaire et l’autogreffe conjonctivo-limbique. Communication Orale, 114eCongrès de la Société Française d’Ophtalmologie (SFO 2008) ,Du 10 mai au 14 mai 2008 Palais des Congrès,JFO Résumés page :1s38 Paris, France.
8. Aydin A, Aykan U, Sabahyildizi M, Ersanli D. The influence of the learning effect on automated perimetry in Turkish people. World Glaucoma Congress 2009, 8-11 July 2009, Boston, MA USA.
9. Tanyuksel M, Aydin A, Unal MH, Ersanli D, Ozyurt M, Koru O, Araz E, Kilbas ZG. Acanthamoeba keratitis in a pregnant contact lens wearer in Turkey. Poster presentation, 58thAnnual Meeting of ASTMH (American Society of Tropical Medicine and Hygiene) November  18-22, 2009, Washington, D.C., USA.
10. Salcan I, Akyan U, Colakoglu K, Aydin A, Ersanli D. The correlation of angle opening distance, angle recess area and trabecular-irisangle in the quantitative evaluation of the anterior chamber angle by ultrasound biomicroscopy. 9th European Glaucoma Society Congress 12-17 September 2010, Madrid Spain.
11. Aykan U, Sabahyildizi M, Salcan I, Aydin A, Ersanli D. The outcome of combined laser iridotomy and selective laser trabeculoplasty in a case with bilateral ocular hypertension secondary to pigment dispersion caused by extensive irido-ciliary cysts. 9th European Glaucoma Society Congress 12-17 September 2010, Madrid Spain.
12. Aydın A, Aykan U, Çakır A, Ersanlı D. “Ocular hypertension in isolated extraocular muscle infiltration by leukemia’’ 9th European Glaucoma Society Congress, 12-17 September 2010, Madrid Spain.

Turkish Books Section

Aydin A. Glokomda Yeni ilaçlar ve Modern İlaç Uygulama Yöntemleri. In: Glokom, Temel Kavramlar ve Yenilikler. Ocakoğlu Ö, Bayer A, Elgin U Eds. Anadolu Tıp Kitabevi, Ankara 2021 1st ed. Bölüm 36 p:375-381. ISBN:978-605-80205-3-5.

Awards:

• Ayata A, Aydın A, Duman C, Bilge AH. “Rapunzel” (fotoğraf sunumu) Türk Oftalmoloji Derneği 40. Ulusal Oftalmoloji Kongresi, 405, Antalya, 28 Ekim-01 Kasım 2006. Best medical photograph third award.
• Aydın A. “Akut myeloid lösemili bir hastada gelişen proptozis ve oküler hipertansiyon’’ TOD Glokom Birimi VI. Olgularla Glokom Sempozyumu, 29 Mayıs 2010, Antalya. Best presentation third award.
• Aydın A. ‘Travmatik glokomlu bir hastada trabekülektomi sonrası gelişen akut görme kaybı’’ TOD Glokom Birimi VII. Olgularla Glokom Sempozyumu, 28 Mayıs 2011, Girne. Best Presentation second award.
• Salcan İ, Aykan Ü, Çolakoğlu K, Aydın A, Erşanlı D. “ Sağlıklı, genç, erkek popülasyonda ultrason biyomikroskopi ile saptanan ön kamara açısına ait nicel değerler” 45. TOD Ulusal Kongresi 5-9 Ekim 2011, Girne. Türk Oftalmoloji Dergisi Best article award (second).
• Çolakoğlu K, Aydın A, Kar T, Ayata A, Aykan Ü, Ünal M, Haholu A, Erşanlı D.Trabekülektomi uygulanan tavşanlarda bevacizumab’ın konjonktival yara iyileşmesi üzerine etkisi. Glokom-Katarakt Dergisi 2014;9(3):167-172. Glokom -Katarakt Dergisi 2014 best research 1st award.

Total citations: 896 (as of May 2021)

he top 10 publications with the most citations

1. Optical Coherence Tomography Longitudinal Evaluation of Retinal Nerve Fiber Layer Thickness in Glaucoma
   May 2005 · Archives of Ophthalmology
   289 Citations
2. Optical Coherence Tomography (OCT) macular and peripapillary retinal nerve fiber layer measurements and automated visual fields
   Sep 2004 · American Journal of Ophthalmology
   186 Citations
3. Comparison of optic nerve head measurements obtained by optical coherence tomography and confocal scanning laser ophthalmoscopy
   May 2003 · American Journal of Ophthalmology
      153 Citations
4. Optical Coherence Tomography Assessment of Retinal Nerve Fiber Layer Thickness Changes after Glaucoma Surgery
   Aug 2003 · Ophthalmology
   77 Citations
5. Comparison of transepithelial corneal collagen crosslinking with epithelium-off crosslinking in progressive keratoconus
   May 2014 · Journal francais d'ophtalmologie
   41 Citations
6. Validation of the Ocular Trauma Score for Intraocular Foreign Bodies in Deadly Weapon-Related Open-Globe Injuries
   Mar 2008 · Ophthalmic Surgery Lasers and Imaging
   29 Citations
7. Evaluating pulsatile ocular blood flow analysis in normal and treated glaucomatous eyes
   Oct 2003 · American Journal of Ophthalmology
   19 Citations
8. A role for repressive complexes and H3K9 di-methylation in PRDM5-associated brittle cornea syndrome. September 2015 Human Molecular Genetics
   11 Citations
9. [Effectiveness of topical ciclosporin A treatment after excision of primary pterygium and limbal conjunctival autograft] October 2008 Journal Francais d'ophtalmologie
   10  Citations
10. [Orbital varix presenting with enophthalmos. A case report].
    May 2010 · Journal francais d'ophtalmologie
    10 Citations

HOMO HOMINI MEDICUS. Eclectic surgeon, specialist in orthopedics and traumatology, pioneer of endoscopic surgery, radio-guided and minimally invasive robotics of the spine and small and large joints (knee, hip, foot, shoulder, elbow and wrist). He combines surgery with regenerative medicine, which he was the first to launch in Italy and Europe, with the use of FSV cells (Stromal Vascular Fraction, particularly rich in stem cells). Adolfo Panfili boasts a prestigious scientific and sporting curriculum of international importance, as well as being an expert in homeopathy, homotoxicology, phytotherapy, acupuncture and BEST chiropractic. Expressly commissioned by his teacher, Prof. Linus Pauling (multiple Nobel Prize winner), inventor of Orthomolecular medicine, he founded AIMO, (International Association of Orthomolecular Medicine), revisiting this science and merging it with other super-specialist branches, including regenerative medicine , aimed at restoring and repairing cartilage, bone and joint structures, vertebral discs, ligaments, tendons, etc.

Prof Adolfo Panfili, orthopedic surgeon with a very long CV of international standing. He is president of AIMO, the International Association of Orthomolecular Medicine of which he is the founder. He was a student of the double Nobel Prize winner Linus Pauling, inventor of Orthomolecular medicine. Prof Panfili has revisited and expanded this science by merging it with other sciences and techniques including the use of Stromal Vascular Fraction.

– He is Deputy Rector for International Relations as well as Dean of the Master's Faculty of Orthomolecular Sciences at the Popolare University of Milan;

– He is the first to have carried out minimally invasive robotic surgery in orthopedics in Italy with the Mazor system;

– He is Trainer and Proctor of Dtrax, a minimally invasive posterior cervical fusion and distraction system;

– He is the Director of various High Technology Minimally Invasive Spinal Surgery Centers accredited with the NHS and otherwise;

– He is the founder and director of the first Italian Center for Minimally Invasive Robotic Spine Surgery and one of the most eminent members of robotic surgery at the “International Academy for Robotic Spine Surgery”;

Prof. Panfili has been treating vertebrae, posture and nutrition in close synergy since the beginning of his thirty-year professional activity, both from a surgical and manipulative point of view, being among other things the first orthopedist in Europe to graduate in Best Chiropractic with Prof. Ted Morter, one of the best chiropractors in the world, of whom he was the best European student.

– He is currently a pioneer in the use and application of the Stromal Vascular Fraction in the field of well-being, anti-aging and longevity, with particular reference to orthopaedics, the spine and cervical, the aspect of cartilage damage for prevention of degenerative diseases of the hips, knees and intervertebral discs.

Le médecin a effectué des stages éducatifs et des séjours d'études dans divers services et hôpitaux. Il a également travaillé à plein temps dans le service d'orthopédie de l'hôpital universitaire de Brno depuis 1988 et a mené des activités de recherche sur le traitement des défauts du cartilage des articulations de soutien. En outre, ils ont participé à des activités éducatives et sont membres de plusieurs organisations professionnelles et scientifiques. Ils sont spécialisés dans la médecine sportive, la traumatologie sportive et l'endoprothèse dans toutes les localisations. Ils sont également auteurs et co-auteurs de 91 conférences et de 38 publications.

Le service de chirurgie de la main de l'hôpital universitaire HM Montepríncipe est dirigé par le Dr Pedro J. Delgado et soutenu par les Dr Fernando Polo et Belén García Medrano, qui ont tous deux une grande expérience de la chirurgie de la main.