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The extension of fractures of the extremity bones became more reliable when the Marburg surgeon Rudolf KLAPP (1873-1948) introduced strong steel wires. This fixation technique was further improved by Martin KIRSCHNER (1879-1942).
KIRSCHNER was born on 28.10.1879 in Breslau, the son of a lawyer - scion of a surgeon family. Studied in Freiburg, then Strasbourg, Zurich and Munich. Finally he was back in Strasbourg. Here he received his approbation on 9.7.1904 and on 20.9.1904 doctoral thesis with a thesis on syringomyelia. 1904-1907 Assitent at the Municipal Hospital Moabit in Berlin. 1908-1910 assistant of PAYER at the Surgical University Clinic in Greifswald, 1910-1913 assistant at the University Hospital of Königs- burg, there habilitation as Privatdozent in the winter semester 1910/11 with a thesis on tendon and fascia transplantation. 1913 professor title. Student of Friedrich TRENDELENBURG (1844-1924).
From 1909 he examined the tensile forces on the skeleton and developed improved methods of osteosynthesis. His experiments with thin wires finally led to a still recognized method, the wire respectively. Pinning.
From 1916-1927 he was a professor at the University of Königsberg. In 1924 he succeeded here the first embolectomy (named after his teacher as TRENDELENBURG'sche operation) from a v. Chr. pulmonalis: on April 23, 1924, Martin Kirschner was able to report during the 48th session of the German Society for Surgery of Johanna Kempf, a patient with massive pulmonary embolism, which could be rescued by the operation developed by Trendelenburg. 1927 change to Tübingen. At first he refused the Rud to Heidelberg, which he had received in 1932, because he was not given the full promise for a new hospital building. It was not until 1934 that this promise was finally given to him, so that he now moved to Heidelberg and took over here the Surgical Clinic. In the same year 1934 he became chairman of the German society for surgery.
Kirschner died on August 30, 1942 in the Heidelberg reserve hospital - a gastric carcinoma with metastases.
By setting up surveillance rooms for freshly-operated people, KIRSCHNER became a pioneer of German intensive care medicine. The treatment of pylorospasm in infants also occupied Kirschner intensively, as did prostate surgery. He developed an operation to replace the esophagus. Popular is his square abdominal ceiling holder for laparatomy. Above all, however, KIRSCHNER revolutionized the treatment of broken bones. The named after him Kirschner wire osteosynthesis, a "semi-operative" method, is still today for many fractures optimal care.
Despite all the technology, the surgeon's personal abilities remain crucial for the success or failure of an operation: "Not the operation, but the surgeon saves the patient" (Kirschner).
Spiked wire osteosynthesis (pinning): Fixation method, as it is preferably applied to the typical spoke break near the wrist, for example. The bone fracture is established under X-ray imager control. So that the break remains in the position achieved, 2-3 wires (med. Kirschner wires) are introduced through the skin with a drill. The wires are shortened and sunk under the skin. The inserted wires bridge and stabilize the bone fracture. However, an additional plaster rest of about 4 weeks to the healing of the fracture is necessary because this supply is not exercise-stable.
In addition to the spiked wires KIRSCHNER 1927 gave a semi-open procedure, to immobilize a fracture by extension of bone: a directly on the bone attacking train bandage for position correction (reduction), for on-site retention (retention) of bone fragments in bone fractures, but also occasionally Fragment dislocation (distractor) in extension osteotomy, contracture mobilization, levitation, etc .; the pulling action is by metered, over rolls - e.g. of a Perforated Rod Device - Guided Weight Traces that Attack a Bone Wire Driven by the Bone, or a STEINMANN Nail Tensioned in the "Extension Bar."
Presented are three large "KIRSCHNER brackets" and a small so-called "American bracket" with transverse adjustment bar from the inventory of the Elisabethklinik, used around 1970 by Dr. med. Roger FROMES.
Lit.:
Kirschner, Martin & Stauss, Beiträge zur willkürlichen Begrenzungn und zur individuellen Dosierung der Spinalanästhesie. Erfahrungen an über 1000 Fällen (S.322-383, 26 Abb.), in: Verh. Dtsch. Ges. Chir., 56. - Berlin, Julius Springer, 1932, 8°, CXVIII, 856 S., 260 Abb.
Kirschner, Martin: Die Hochdrucklokalanästhesie. Berlin, Springer-Verlag, 1944, 8°, 62 S., 32 z.T. farb. Abb., OKartBd. Erste Auflage der letzten und posthum erschienen Arbeit von Martin Kirschner hrsg. v. R.Zenker
Weißer, Christoph: Die Knochenbruchbehandlung bei Martin Kirschner und die Entwicklung des „Kirschnerdrahtes“. Anmerkungen zu einer genialen Idee in der Chirurgie, in: Würzburger Medizinhistorische Mitteilungen 12 (1994) S. 5-18.
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