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Report of the Historian

This report delves into the historical contributions of notable surgeons like Ernst Weber and Jan F. S. Esser, discussing their innovative techniques and enduring influence on modern flap surgery. It also sheds light on figures like Curt Schimmelbusch and their lasting impact on surgical practices. Furthermore, the narrative explores the intriguing link between handedness and influential individuals of the 20th century. The document examines the evolution of hand surgery procedures, from ancient times to contemporary practices, providing a comprehensive overview of this specialized field.

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Report of the Historian

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

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

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

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

  5. Igino Tansini‘s description ofthe latissimus dorsi flap and his merits for modern flap surgery Sopra il mio nuovoprocesso di ampu-tazione della mamella.Gazzetta Medica Italiana (1906) 12: 757

  6. 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

  7. 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

  8. 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

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

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

  11. 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 and 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)

  12. 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

  13. Curt Schimmelbusch (*1860 +1895)Surgeon, pathologist • White hospital clothes • Sterile o.r. coats / coverages • Steam-sterilized instruments • Sterile mask (used until WW2)

  14. Schimmelbusch‘s flap (1892) • Axial osteo-cutaneous temporo-parietal flap to reconstruct the cheek Total nosereconstruction

  15. 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

  16. On the potential influence of one-handedness on politics and philosophy of the 20th 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)

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