1 / 26

Report of the Historian

Report of the Historian. Andreas Gohritz. FESSH Council Meeting December 5-6th, 2010, Firenze. FESSH 2010, Bukarest Instructional Course: History of Microsurgery in Hand Mutilation – The European Perspective. Andreas Gohritz, Edgar Biemer Hannover, Munich / Germany.

angulod
Download Presentation

Report of the Historian

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Report of the Historian Andreas Gohritz FESSH Council Meeting December 5-6th, 2010, Firenze

  2. FESSH 2010, BukarestInstructional Course:History of Microsurgeryin Hand Mutilation –The European Perspective Andreas Gohritz, Edgar Biemer Hannover, Munich / Germany

  3. Invited article:Edgar Biemer – 40 years of Microsurgery in EuropeA. Gohritz, T. KipelspergerChir Main (2011) Pioneers of Hand Surgery Tubiana, Moberg, …

  4. Invited Lecture:Themistocles Gluck (1853-1942) - an early Romanio-German visionary of replacement surgery

  5. Who Was the First in History to Treat Radial Palsy by Tendon Transfer?Korteweg et al. PRS 2010; 125: 756Tomasz Z. Drobnik (Poland, *1858 +1901), 1894ECRL  EDC, ECRB (partial)  EPLHowever: Patient with Poliomyelitis !

  6. Who Was Really the First in History to Treat Radial Palsy by Tendon Transfer?Felix Franke (*1860 +1937) 8-y-old patient with radial palsy(e-physiologically confirmed)FCU  EDC, FCR  APL / EPB, Tenodesis ECRL/B 1st idea: Franke F. Ueber Sehnenüberpflanzung. Arch Klin Chir 1896; 52: 87-91.

  7. Felix Franke. Ueber die operative Behandlung der Radialislähmung nebst Bemerkungen über die Sehnenverpflanzung bei spastischen Lähmungen. Arch Klin Chir 1898; 57: 763 „… I have the right to say that there is no more unhealible radial palsy, at least if there is either the median or ulnar nerve unparalyzed“. Published in PRS October 2010

  8. Neovascularisation = important factor in chronic pain syndromes, e. g. elbow, achilles tendon, wrist, …

  9. Schreibekrampf = writing crampDr. F. Runge, Berliner Medizin Wochenschr (1873) […] a point near the external epicondyle, exactly where the supinator longus, extensor carpi und digitorum communis have their origin, a small spot, which is not only painful, but also triggers violent reflex movements when pressed upon. = 1st description of elbow epicondylitis ? …. I applied on the painful spot a cauterium which destroyed all the skin … with this scarring also occurred, as i suppose, a destruction of the deeper vessels and a complete remission of the painful periosteal spot. = 1st description of sclerotherapy ?

  10. Dr. Runge – German pioneer of sclerosing therapy in epicondylitisKnobloch K, Gohritz A.Brit J Sports Med – e-published November 2010

  11. Fat grafting to dorsum of hand –our future responsibility ?

  12. Injection of human fat since 1906, first report in 1910 Correction of „repulsive skull-like appearance of face“, patient „very satisfied“, regained job

  13. Eugen Holländer (*1867, +1932) –a widely forgotten pioneer ofaesthetic surgery, fat injection and medical art history in GermanyAndreas GohritzMedizinische HochschuleHannover

  14. Holländer‘ s technique Fat taken from hernia, lipoma or grafts- 3 h of cooking, 2 days of resting- Cooking again before use- Mixture of ram‘ s and human fat to minimize reabsorption- „homogenous filling“ using thin cannulas „without particular pain“- voluminous (over)-filling (Over-correction) Similarities, but also fundamental (!) differences to modern procedure

  15. Numerous appplications in the face, breast and painful scars From: Holländer 1932

  16. On the historical development of muscle and nerve transfer operations in the late 19th / early 20th century in Germany Andreas Gohritz, Jan Fridén*, Peter M. Vogt Medizinische Hochschule Hannover Sahlgrenska Universitet, Göteborg, Schweden*

  17. Introduction Our standard techniques = mostly concepts created around end 19th / early 20th century, Above all by German surgeons / orthopaedics - Treatment of poliomyelitis - Therapy of gun shot wounds (WW1) Group of shoulder, Elbow / upper arm Gun shot wounds During treatment Flail („floppy“) shoulder due to polio

  18. Objective = Analysis of historical development of muscle / nerve transfer operations • Insight in historial back ground • Presentation of important protagonists K. Biesalski E. Lexer F. Lange G. Perthes O. Foerster

  19. Konrad Biesalski – Father of „Krüppelfürsorge“ (cripple care) Konrad Biesalski Konrad Biesalski (1868-1930) School doctor, Orthopaedic surgeon Country-wide „cripple-count“ 1907  75 183 children, 15% paralyses Initiator of „Krüppelfürsorge „ = Care / therapy of handicapped 1914: 111 (!) Homes and Counsel centers

  20. Comprehensive rehabilitation of handicapped people of all kind • „Cripple“ = healable patient  Special care („Fürsorge“) Goal = professional / social reintegration • („from mere beggar • … to tax-payer“) • Collection of patients • Innovative methods • „War cripple“ care Borggreve-Plastik 1929 (Ankle = Knee substitution)

  21. „The Physiological Tendon Transfer“ (1916)Konrad Biesalski, Leo Mayer (USA) Leo Mayer (li.) and Oskar Biesalski (re.), Mayer until 1917 in Berlin, later pioneer of orthopaedic / hand surgery in USA / Israel

  22. „Die physiologische Sehnenverpflanzung“ • = Standard work on • tendon transfer until today • theoretical principles • clinical application Sublimis (=FDS)-Transfer for finger extension - 44 Jahre before Boyes ! • tendinous (Vulpius) vs. periostal fixation (F. Lange)? • Prevention scars / adhesions • (Fish bladder vs. old tendon sheath)

  23. Nicolaus Rüdinger (*1832 +1896) Barber, Surgeon, Anatomist Munich, Germany • 1st Photographical Atlas in Anatomy (1871) • Embalmed Ludwig II (1888)

  24. Joint denervation • Upper extremity • Shoulder • Elbow • Wrist • Finger joints • Thumb joints • Lower extremity • Knee • Sinus tarsi Lee A. Dellon

  25. “The Joint Nerves of the Human Body“ (1847) “ there is only here and there mention of nerve branches going to a joint …“

  26. Thank you for your kind attention.

More Related