Report of the Historian Andreas Gohritz FESSH Council

Report of the Historian Andreas Gohritz FESSH Council Meeting June 3 rd, 2009, Posznan

Histories of national societies of surgery of the hand New contributions: 1. Spain (Marc Garcia-Elias) 2. Poland ( Congress 2009) 3. Russia (Igor Goloubev) 4. Turkey (Ayan Gülgönen)

Linked Web-site on History of Hand Surgery Journals (Pubmed, Science direct): • Biographies / Orbituaries • Procedures / Techniques • Associations / Meetings

Ernst Weber „Über den Tastsinn“ (About the sense of touch), 1834 Weber test = Two-point-discrimination Lee A. Dellon

Igino Tansini‘s description of the latissimus dorsi flap and his merits for modern flap surgery Sopra il mio nuovo processo di amputazione della mamella. Gazzetta Medica Italiana (1906) 12: 757

Principles of Tansini‘s new method • Axial vascular pedicle of flap • Integrity of muscle-skin-unit • Importance of perforators = Fundament of all modern flap techniques, including perforator flaps

Jan F. S. Esser (*1877 +1946) A man of many talents • Chess master (Dutch champion 1913) • Art collector (collection of > 880 paintings) • Stock exchange speculator (> 200 houses in Berlin) • Universal surgical genius

Surgical innovator 1915 -1925 > 10 000 Reconstructive operations of the whole body: (Face, hand, breast, bladder, anus… • • Bilobed flap / Cheek rotation 1918 Epithelial Inlay 1919 Osteocutaneous flaps Biological flaps (1931) Pedicle only with vessel and nerve “Integrity of the vessel-nerve string“ = Precursor of perforator flaps

Innovative hand surgeon: Multiple toe-midfoot-to-hand transfer

Pedicled transfer and cast immobilisation over 4 weeks (Patient fell out of bed the 1 st night)

Postoperative Result • Esser JFS. Ersatz der Mittelhand nebst 4 Fingern. Brun‘s Beitr Klein Chir 108: 244 (1917) • Esser JFS, Ranschburg P: Reconstruction of the hand 4 fingers by the middle part of the foot and 4 toes. Ann Surg 111: 655 (1940) 23 -year-follow-up with excellent result (1940)

Esser‘s great dream „Free state of Reconstructive Surgery“ Objective: - Neutral, independant territor (island) - Plastic surgical treatment, totally free of charge → No success in Europe until 1939 1940: Emigration to USA, Return to Europa impossible Loss of fortune at the Wall Street, Complete poverty, 1946: Death in Chicago

Curt Schimmelbusch (*1860 +1895) Surgeon, pathologist • • White hospital clothes Sterile o. r. coats / coverages Steam-sterilized instruments Sterile mask (used until WW 2)

Schimmelbusch‘s flap (1892) • Axial osteo-cutaneous temporo-parietal flap to reconstruct the cheek Total nose reconstruction

Sudden death in 1895 Aged only 34 years due to unclear cause - but most probably sepsis after infection during experiments Schimmelbusch‘s letter describing his illness

On the potential influence of onehandedness on politics and philosophy of the 20 th century accepted J Hand Surg A 2009 (Letter) Ludwig (philosopher), Paul Wittgenstein (pianist) Wilhelm II (left Erbs palsy) „An English-man has crippled my arm“ “ 1. If you do know there is a hand, we'll grant you all the rest. 2. From its seeming to me, or to anyone, to be so, it doesn't follow that it is so. ” (On Certainty, 1951)