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Report of the Historian

This report discusses the historical treatment of radial palsy through tendon transfer, focusing on the contributions of Felix Franke and Tomasz Drobnik. It also explores the impact of neovascularization and the early discoveries in elbow epicondylitis and sclerotherapy. The report also highlights the forgotten pioneer Eugen Holländer and the use of fat grafting in aesthetic surgery. The role of Konrad Biesalski in poliomyelitis treatment and Leo Mayer's work on physiological tendon transfer are also discussed. Additionally, the report explores the influence of hand diseases on the lives of musicians and painters.

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Report of the Historian

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

  2. 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 !

  3. 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.

  4. 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

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

  6. Schreibekrampf = writing crampF. 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. = 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 ?

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

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

  9. Eugen Holländer (*1867, +1932) –a widely forgotten pioneer ofaesthetic surgery, fat injection and medical art history in GermanyAndreas GohritzEURAPS Meeting, Mykonos 2011IPRAS News, June 2011

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

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

  12. 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 German Hand Society Meeting 2011

  13. Introduction Our standard techniques = mostly concepts created around end 19th / early 29th 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

  14. 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

  15. 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)

  16. „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

  17. „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)

  18. Influence of Hand Disease on Life and Work of FamousMusicians 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

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

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

  21. Thank you for your kind attention.

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