Report of the Historian Andreas Gohritz FESSH Deleguates

Report of the Historian Andreas Gohritz FESSH Deleguates Meeting May 27 th, 2011, Oslo

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

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 1 st idea: Franke F. Ueber Sehnenüberpflanzung. Arch Klin Chir 1896; 52: 87 -91.

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

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

Schreibekrampf = writing cramp F. Runge, Berlin 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. = 1 st 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.

Dr. Runge – German pioneer of sclerosing therapy in epicondylitis Knobloch K, Gohritz A. Brit J Sports Med – published November 2010

Fat grafting to dorsum of hand – our future responsibility ? Coleman S. et al 2005

Eugen Holländer (*1867, +1932) – a widely forgotten pioneer of aesthetic surgery, fat injection and medical art history in Germany Andreas Gohritz EURAPS Meeting, Mykonos 2011 IPRAS News, June 2011

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

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

On the historical development of muscle and nerve transfer operations in the late 19 th / early 20 th century in Germany Andreas Gohritz, Jan Fridén, Peter M. Vogt German Hand Society Meeting 2011

Introduction Our standard techniques = mostly concepts created around end 19 th / early 29 th century, Above all by German surgeons / orthopaedics - Treatment of poliomyelitis - Therapy of gun shot wounds (WW 1) Group of shoulder, Elbow / upper arm Gun shot wounds During treatment Flail („floppy“) shoulder due to polio

Konrad Biesalski – Father of „Krüppelfürsorge“ (cripple care) 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

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)

„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

„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)

Influence of Hand Disease on Life and Work of Famous Musicians and Painters Clara Schumann – Overuse Pain Syndrome / Focal Dystonia ? Robert Schumann – Focal Dystonia, PIN Compression ? Nicolo Paganini / Sergej Rachmaninoff – Marfan Syndrome Django Reinhard – Burn Contractures of Fingers Paul Wittgenstein, Rick Allen – Upper Arm Amputation Peter Paul Rubens, Auguste Renoir – Rheumatoid Arthritis Paul Klee - Scleroderma

Rick „Thunder God“ Allen (*1963) Drummer of Def Leppard Two drum sticks in one hand Special foot pedals

Django Reinhardt (*1910 +1953) Own grip techniques Own Sound

Thank you for your kind attention.