Otfrid Foerster (1873–1941)—Self-Taught Neurosurgeon and Innovator of Reconstructive Peripheral Nerve Surgery

Andreas Gohritz; Lee A. Dellon; Merlin Guggenheim; Marcus Spies; Andreas Steiert; Peter M. Vogt

doi:10.1055/s-0032-1326737

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2013; 29(01): 033-044
DOI: 10.1055/s-0032-1326737

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Otfrid Foerster (1873–1941)—Self-Taught Neurosurgeon and Innovator of Reconstructive Peripheral Nerve Surgery

Authors

Andreas Gohritz

¹Department of Plastic, Hand and Reconstructive Surgery, Medizinische Hochschule, Hannover, Germany
Lee A. Dellon

²Department of Plastic Surgery/Neurosurgery, Johns Hopkins University, Baltimore, MD
Merlin Guggenheim

³Clinic for Reconstructive Surgery, University Hospital, Zurich, Switzerland
Marcus Spies

⁴Department of Plastic, Hand and Reconstructive Surgery, Barmherzige Brüder Hospital, Regensburg, Germany
Andreas Steiert

¹Department of Plastic, Hand and Reconstructive Surgery, Medizinische Hochschule, Hannover, Germany
Peter M. Vogt

¹Department of Plastic, Hand and Reconstructive Surgery, Medizinische Hochschule, Hannover, Germany

Abstract

Otfrid Foerster (1873–1941) became a self-taught neurosurgeon during and after WW I, playing a critical role in the development of peripheral nerve reconstruction. Although best known for describing dermatomes, he published over 300 articles on the nervous system. Confronted by thousands of nerve injuries during WW I, as well as poor results and disinterest from his surgical colleagues, Foerster began performing neurolysis and tension-free nerve repairs himself under emergency conditions. He pioneered grafting motor nerve defects by expendable cutaneous nerves (e.g., sural) and performed intraplexal neurotizations and various nerve transfers, such as the pectoral, subscapular, long thoracic, and thoracodorsal nerves in brachial plexus injuries. Foerster championed rehabilitation, recognizing the potential of electrostimulation and physiotherapy to influence cortical reorganization (brain plasticity) and improve recovery after nerve injury. Foerster died from tuberculosis in 1941, leaving a rich reconstructive peripheral nerve legacy; his innovative and visionary spirit serves as a role model.

Keywords

Otfrid Foerster - peripheral nerve - nerve graft - neurolysis - nerve repair

Full Text

References

Bibliography
1 Santoni-Rugiu P, Sykes PJ . A History of Plastic Surgery, Springer Berlin, 2007
2 Jefferson G. Otfrid Foerster. Lancet 1941; 2: 503
3 von Weizsäcker V. Otfrid Foerster 1873–1941. J Neurol 1941; 1–2: 1-23
4 Kennard MA, Fulton JF, Gutiérrez-Mahoney CG. Otfrid Foerster 1873–1941. Acta Neurol Physchiatry 1941; 46: 913-918
5 Kennard MA, Fulton JF, Gutiérrez-Mahoney CG. Otfrid Foerster 1873–1941. An appreciation. J Neurophysiol 1942; 5: 1-17
6 Greenberg SA. The history of dermatome mapping. Arch Neurol 2003; 60: 126-131
7 Gutierrez-Mahoney CG. Otfrid Foerster 1873–1941. Arch Neurol Psychiatry 1941; 46: 913-918
8 Marshall C. Otfrid Foerster (1873–1941). In: Walker AE, , ed. A History of Neurological Surgery. New York: Hafner Publishing Company; 1967
9 Vilensky JA, Gilman S. Using extirpations to understand the human motor cortex: Horsley, Foerster, and Bucy. Arch Neurol 2003; 60: 446-451
10 Wallesch CW. Otfrid Foerster (1873-1941): German neurologist, neurosurgeon and system physiologist. Cortex 2007; 43: 491-493
11 Zülch KJ. Otfrid Foerster, an appreciation (1873–1941). J Neurol Sci 1968; 6: 384-385
12 Zülch KJ. Otfrid Foerster. Arzt und Naturforscher (9.11.1873 - 15.6.41). Berlin, Heidelberg: Springer-Verlag; 1969
13 Zülch KJ. Otfrid Foerster 1873–1941. Surg Neurol 1973; 1: 313-316
14 Foerster O. Demonstration: Die Schussverletzungen der peripheren Nerven und ihre Behandlungen. (Demonstration: Gunshot injuries to peripheral nerves and their treatment.). Berl klin Wschr 1915; 52: 823-827
15 Foerster O. Die Schussverletzungen der peripheren Nerven und ihre Behandlung. (The gun shotinjuries to peripheral nerves and their treatment.). Z. Orthop. Chir. 1916; 36: 310-318
16 Foerster O. Die Symptomatologie und Therapie der Kriegsverletzungen der peripheren Nerven (Symptomatology and therapy of war injuries of peripheral nerves). Dtsch Z Nervenh 1918; 59: 32-172
17 Foerster O. Kriegsverletzungen des Rückenmarks und der peripheren Nerven. (War injuries of the spinal cord and peripheral nerves) Schjornigs Handbuch der ärztlichen Erfahrungen im Weltkrieg 1914–18. 1922; 4: 235-332
18 Foerster O. Die operative Behandlung der Schussverletzungen der peripheren Nerven. (Operative therapy of gunshot injuries to peripheral nerves). Münch Med Wochenschr 1934; 81: 1183-1187
19 Foerster O. Demonstration: Spätoperation nach Schussverletzungen peripherer Nerven. etc. (Demonstration: Late operation after gunshot injury to peripheral nerves etc.) Klin Wschr 1929; 8: 522; 232
20 Foerster O. Die Symptomatologie der Schussverletzungen der peripheren Nerven. (Symptomatology of gunshot injuries to the peripheral nerves) Bumke u. Foersters Handb. Neurol. (Lewandowsky) 1929; 3: 975-1508 (Ergänzbd.)
21 Foerster O. Die Therapie der Schussverletzungen der peripheren Nerven. (Therapy of gunshot injuries to the peripheral nerves) Bumke u. Foersters Handb. Neurol. (Lewandowsky) 1929; 3: 1509-1720 (Ergänzbd.)
22 Hohmann G. Was verdanken wir Otfrid Foerster? (What do we owe to Otfrid Foerster? ). Zeitschr Orthop und ihre Grenzgeb 1941; 72: 279-284
23 Lorenz R. The significance of Otfrid Foerster's work for the Deutsche Gesellschaft für Neurochirurgie. Zentralbl Neurochir 1991; 52: 149-152
24 Piotrowska N, Winkler PA. Otfrid Foerster, the great neurologist and neurosurgeon from Breslau (Wrocław): his influence on early neurosurgeons and legacy to present-day neurosurgery. J Neurosurg 2007; 107: 451-456
25 Sarikcioglu L. Otfrid Foerster (1873–1941): one of the distinguished neuroscientists of his time. J Neurol Neurosurg Psychiatry 2007; 78: 650
26 Tan TC, Black PM. Otfrid Foerster – his contributions to neurology and neurosurgery. Neurosurgery 2001; 49: 1231-1235 , discussion 1235–1236
27 Tan TC. Otfrid Foerster (1873-1941). J Neurol 2003; 250: 513-514
28 Wroński J. Foerster's activity and neurosurgery in Wrocław (Breslau). Zentralbl Neurochir 1991; 52: 153-163
29 Zulch KJ. [Reminiscences of Otfrid Foerster]. Zentralbl Neurochir 1954; 14 (4-5) 286-292
30 Wartenberg R. Otfrid Foerster. In: Haymaker W, Schiller F, , eds. The Founders of Neurology. 2nd ed. Springfield, IL: Charles C Thomas Publisher; 1970
31 Bucy PC. Neurosurgery in darkness. Surg Neurol 1978; 9: 360
32 Penfield W. No Man Alone. A Neurosurgeon's Life. Boston: Little, Brown and Company; 1977
33 Bailey P. Up from Little Egypt. Chicago: Buckskin Press; 1969
34 Silver JR. History of the Treatment of Spinal Injuries. Dordrecht: Kluwer Academic/Plenum Publishers; 2005
35 Bumke O. Erinnerungen und Betrachtungen. 2. ed. München: Pflaum; 1953
36 Arnold H. German neurosurgery in the first half of the 20th century. Zentralbl Neurochir 2001; 62: 15-18
37 Cairns H, Brain WR. Otfrid Foerster. Brit Med J 1941; 2: 634
38 Klatzko I, Zu Rhein G. Cécile and Oskar Vogt - the visionaries of modern neuroscience. Acta Neurochirurgica, Supplementum 80. Vienna New York: Springer; 2002
39 Foerster O. Ansprache zur 15. Jahresversammlung der Ges. Dtsch. Nervenärzte 1925. (Speech at the 15th annual meeting of the Society of the German Neurologists). Dtsch Z Nervenheilkd 1926; 88: 99-113
40 Foerster O. Surgical treatment of neurogenic contractures. Surg Gynecol Obstet 1931; 52: 360-366
41 Foerster O. Beitrag zum Werte fixierender orthopädischer Operationen bei Nervenkrankheiten. (Contribution on the value of fixating operations in nerve pathologies). Acta Chir Scand 1930; 67: 351-376
42 Foerster O. Über die Bedeutung und Reichweite des Lokalisationsprinzips im Nervensystem (On the significance and scope of the localization principle in the nervous system). Verh Dtsch Ges Inn Med 1934; 46: 117-211
43 Foerster O. Über eine neue operative Methode der Behandlung spastischer Lähmungen mittels Resektion hinterer Rückenmarkswurzeln (About a new method to treat spastic paralyses through resection of posterior spinal cord roots). Z Orthop Chir 1908; 22: 203-223
44 Foerster O. Übungstherapie (Exercise therapy). In: Bumke O, Foerster O, , eds. Handbuch der Neurologie, vol. 8. Berlin: Springer; 1936
45 Foerster O. Vorderseitenstrangdurchschneidung im Rückenmark zur Beseitigung von Schmerzen (Transsection of the spinothalamic tract of the spinal cord for treatment of pain). Berl Klin Wochensch 1913; 50: 1499-1500
46 Buchfelder M. From trephination to tailored resection: neurosurgery in Germany before World War II. Neurosurgery 2005; 56: 605-613 , discussion 605–613
47 Penkert G, Fansa H. Peripheral Nerve Lesions. Nerve Surgery and Secondary Reconstructive Repair. Berlin: Springer Verlag; 2004
48 Dellon AL, Ferreira MC, Williams EH, Rosson GD. Which end is up? Terminology for terminolateral (end-to-side) nerve repair: a review. J Reconstr Microsurg 2010; 26: 295-301
49 Kale SS, Glaus SW, Yee A , et al. Reverse end-to-side nerve transfer: from animal model to clinical use. J Hand Surg Am 2011; 36: 1631-1639 , e2
50 Oberlin C, Béal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am 1994; 19: 232-237
51 Mackinnon SE, Colbert SH. Nerve transfers in the hand and upper extremity surgery. Tech Hand Up Extrem Surg 2008; 12: 20-33
52 Dellon AL. The sensational contributions of Erik Moberg. J Hand Surg [Br] 1990; 15: 14-24
53 Dellon AL. Evaluation of Sensibility and Re-Education of Sensation. Baltimore: Williams & Wilkins; 1981
54 Mackinnon SE, Dellon AL. Surgery of the Peripheral Nerve. New York: Thieme; 1988
55 Dellon AL. Somatosensory Testing & Rehabilitation. Bethesda: Amer. Occupational Therapy Association Pub; 1997
56 Lundborg G. Brain plasticity and hand surgery: an overview. J Hand Surg [Br] 2000; 25: 242-252
57 Lundborg G. Nerve Injury and Repair. Regenerative Reconstruction and Cortical Remodeling. Philadelphia: Elsevier Churuchill Livingstone; 2004
58 Naff NJ, Ecklund JM. History of peripheral nerve surgery techniques. Neurosurg Clin N Am 2001; 12: 197-209 , x
59 Hanigan W. The development of military medical care for peripheral nerve injuries during World War I. Neurosurg Focus 2010; 28: E24
60 Platt H. On the results of bridging gaps in injured nerve trunks by autogenous fascial tubulization and autogenous nerve grafts. Br J Surg 1919; 7: 384-389
61 Bunnell S, Boyes H. Nerve grafts. Am J Surg 1939; 44: 64
62 Terzis JK, Sun DD, Thanos PK. Historical and basic science review: past, present, and future of nerve repair. J Reconstr Microsurg 1997; 13: 215-225
63 Seddon H. Surgical Disorders of the Peripheral Nerves. Edinburgh: Churchill Livingstone; 1972
64 Woodhall B, Beebe G , eds. Peripheral Nerve Regeneration: a Follow-up Study of 3,656 World War II Injuries. Washington, DC: Veteran's Administration; 1956
65 Brooks D. The place of nerve-grafting in orthopaedic surgery. J Bone Joint Surg Am 1955; 37-A: 299-305 , passim
66 Seddon HJ Surgical Disordes of the Peripheral Nerves. Edinburgh & London: Churchill Livingstone Ltd.; 1972
67 Millesi H, Meissl G, Berger A. Further experience with interfascicular grafting of the median, ulnar, and radial nerves. J Bone Joint Surg Am 1976; 58: 209-218
68 Millesi H, Meissl G, Berger A. The interfascicular nerve-grafting of the median and ulnar nerves. J Bone Joint Surg Am 1972; 54: 727-750
69 Wood MB, Murray PM. Heterotopic nerve transfers: recent trends with expanding indication. J Hand Surg Am 2007; 32: 397-408
70 Stockinger T, Aszmann OC, Frey M. Clinical application of pectoral nerve transfers in the treatment of traumatic brachial plexus injuries. J Hand Surg Am 2008; 33: 1100-1107