Greeting from the President of Japanese Society for Fracture Repair

President of the Japanese Society for Fracture Repair
Tomoyuki Noda, MD

Greetings to all of the members of the Japanese Society for Fracture Repair (JSFR).

My name is Tomoyuki NODA of the Kawasaki Medical School Department of Orthopaedic Surgery and Traumatology and the Kawasaki Medical School General Medical Center Department of Orthopaedic Surgery. I was appointed as the seventh President of the JSFR at the Board of Directors’ meeting held at the end of June 2023. The roots of JSFR can be traced back to 1978, when Dr. Kisaburo Sakakida (Professor Emeritus, Kyoto Prefectural University of Medicine) held the first meeting of what was then the Research Society for Fracture. Renamed the Japanese Society for Fracture Repair from the 18th Annual Meeting in 1992, this traditional society, which has more than 4,500 members, will celebrate its 50th anniversary next year. I have the privilege of inheriting this important role and the great responsibility it entails from my predecessor, former President Professor Yoshinobu Watanabe, who has contributed significantly to the development of our society over the past four years. It is an honor to take up the position of President, and with the guidance and cooperation of the Board of Directors and the other members of the JSFR, I intend to fully dedicate myself to taking the next step forward, toward the further development of our society.

Orthopaedic trauma surgery, mainly fracture treatment, accounts for about half of all orthopaedic surgeries in Japan, and improving orthopaedic trauma care education and the level of treatment is a critical issue. Moreover, the treatment of orthopaedic trauma is complex and far-reaching, and making full use of the latest knowledge and techniques is necessary in order to achieve good treatment results. However, up until now, many doctors in universities and major hospitals have tended to be more interested in degenerative diseases, and trauma treatment has often received only perfunctory attention. Furthermore, in contrast to Europe and the United States, where each medical region has established its own trauma center-based treatment system, Japanese medical treatment and educational systems still have not reached this level, although there has been a trend toward improvement. Under these circumstances, the role of the JSFR in research, education, and improvement of treatment results in orthopaedic trauma is expected to increase. Following and modifying the manifesto set forth by former President Watanabe, and in cooperation and collaboration with the Board of Directors, committees, and the councilors, we will aim to further develop the JSFR, setting out more specific objectives to be achieved.

1. Education for young orthopaedic surgeons and sharing of the latest knowledge
   The JSFR holds an annual basic course and an advanced course, and with this year marking the 17th time the basic course has been offered, it has contributed to educating many young surgeons about standard treatments for fractures. Considering the aforementioned percentage of orthopaedic trauma surgeries, the basic course plays a very important role, and we will aim to have more orthopaedic surgeons attend, with our ultimate goal being to make the course mandatory for doctors specializing in orthopaedic surgery. The Systematic Review Committee will continue to review papers (the OTAKU project and quick reviews at academic meetings), and together with the advanced course, we will enhance our educational activities, including providing updates for specialists and supervising physicians with an interest in orthopaedic trauma. In addition, we will also begin to revise the guidelines for the treatment of femoral neck/trochanteric fractures, with former President Watanabe serving as committee chair.
2. Establishing registries and promoting activities related to the Public Relations Committee
   The JSFR has created registries and reported on open fractures (DOTJ) and acetabular fractures (AFROS). The registries not only keep track of the number of surgical cases, but also consider the medical resources required for treatment and treatment results. As we believe that they can be used to obtain both evidence regarding treatment methods as well as data for appropriate insurance treatment, we are currently working to launch an advanced version of the aforementioned registries. In relation to this, we have been more proactively involved in the activities of the Japanese Health Insurance Federation for Surgery, and we believe that we played a major role in the recent revision of the additional fee for medical care for early surgery and secondary fracture prevention for proximal femoral fractures. We will continue our activities to promote appropriate insurance points for fracture treatment.
3. Promoting internationalization
   As the world becomes ever-more interconnected and information can be exchanged instantaneously, internationalization is an unavoidable issue to be addressed, and international information-sharing and cooperation are indispensable for the JSFR, together with many other societies. We will strengthen our ties with the Orthopedic Trauma Association (OTA) and the International Orthopaedic Trauma Association (IOTA) in addition to our longstanding exchange programs with Korea and Taiwan, seeking to open up more opportunities for young and mid-career JSFR members to play an active role. Furthermore, as stated in this year's business plan, we will engage in activities geared toward making a bid to host the 2028 IOTA Triennial Meeting. We appreciate the understanding of JSFR members and your cooperation in participating in these international conferences.
4. Active involvement in the treatment of pathological fractures due to bone metastases
   With the growing number of patients with bone metastases in recent years, the importance of active involvement in the treatment of pathological fractures by orthopaedic trauma surgeons and general orthopaedic surgeons has become increasingly recognized. The JSFR has been engaging in activities to raise awareness of pathological fracture treatment, including the knowledge and skills to be acquired and the importance of multidisciplinary cooperation, and we will continue and further expand these activities.
5. Management of JSFR and academic meetings, and review of the name of the society
   I am sure that all of our members are very proud of the fact that over the past 50 years, the JSFR has made a tremendous contribution to the research and treatment of "fractures." That being said, what society is asking of the JSFR along with the scope and themes of our members’ research pursuits are constantly changing, and many of our counterpart societies in developed countries in Europe and the United States are now calling themselves “orthopedic trauma” societies. More specifically, severe open fractures are being treated not only as “fractures” but also as bone and soft tissue complexes through the utilization of free tissue flaps and other approaches, and as spine and spinal cord trauma has also come within the scope of treatment, we believe that the word “fracture” no longer sufficiently expresses all aspects of orthopaedic and musculoskeletal trauma. In the process of renaming the JSFR, we would like to carefully consult with everyone involved, from public comments from JSFR members to discussions with the Board of Directors and the councilors, and we believe that this is one of the issues to be considered. We would also like to propose the rightsizing and review of the finances of conferences and academic meetings in order to ensure the sustainable operation of the JSFR.

I will do my utmost during my time as President to lead the JSFR to the next stage of its development and to open it up to the future and the generations to come. I would like to close by asking all of the JSFR members for your kind support and cooperation, as your help will be indispensable in achieving these goals.