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[History of surgical instruments: 4. The Deschamp ligation needle for the Overholt forceps: development of instruments for blood-saving tissue preparation].

The development of effective ligature carrying forceps is described, which are useful in dissection. The ligature needle, which has been developed by the French surgeon J.F.L. Deschamp (1740-1824), is presented on the basis of his original publication from 1793. Today many surgeons use a ligature forceps, which has been developed in 1938 by R.H. Overholt (b. 1901) in Boston and was modified by R. Geissendörfer (1902-1976) in the 1950s.

Equipment Design↗

Short anterior correction of the thoracolumbar/lumbar curve in King 1 idiopathic scoliosis: the behaviour of the instrumented and non-instrumented curves and the trunk balance.

This is a retrospective clinical, radiological and patient outcome assessment of 21 consecutive patients with King 1 idiopathic adolescent scoliosis treated by short anterior selective fusion of the major thoracolumbar/lumbar (TL/L) curve. Three-dimensional changes of both curves, changes in trunk balance and rib hump were evaluated. The minimal follow-up was 24 months (max. 83). The Cobb angle of the TL/L curve was 52 degrees (45-67 degrees) with a flexibility of 72% (40-100%). The average length of the main curve was 5 (3-8) segments. An average of 3 (2-4) segments was fused using rigid single rod implants with side-loading screws. The Cobb angle of the thoracic curve was 33 degrees (18-50 degrees) with a flexibility of 69% (29-100%). The thoracic curve in bending was less than 20 degrees in 17 patients, and 20-25 degrees in 4 patients. In the TL/L curve there was an improvement of the Cobb angle of 67%, of the apex vertebral rotation of 51% and of the apex vertebral translation of 74%. The Cobb angle of the thoracic curve improved 29% spontaneously. Shoulder balance improved significantly from an average preoperative imbalance of 14.5-3.1 mm at the last follow-up. Seventy-five percent of the patients with preoperative positive shoulder imbalance (higher on the side of the thoracic curve) had levelled shoulders at the last follow-up. C7 offset improved from a preoperative 19.8 (0-40) to 4.8 (0-18) mm at the last follow-up. There were no significant changes in rotation, translation of the thoracic curve and the clinical rib hump. There were no significant changes in thoracic kyphosis or lumbar lordosis. The average score of the SRS-24 questionnaire at the last follow-up was 91 points (max. 120). We conclude that short anterior selective fusion of the TL/L curve in King 1 scoliosis with a thoracic curve bending to 25 degrees or less (Type 5 according to Lenke classification) results in a satisfactory correction and a balanced spine. Short fusions leave enough mobile lumbar segments for the establishment of global spinal balance. A positive shoulder imbalance is not a contraindication for this procedure. Structural interbody grafts are not necessary to maintain lumbar lordosis.

Adolescent↗

[Collapse of the nasal alae and instruments for treating this condition, especially with the Feldbausch nasal dilator. Pictures from the history of otorhinolaryngology, presented by instruments from the collection of the German Museum of Medical History in Ingolstadt].

Although the anatomy of the nasal muscles and the active movement of the nasal alae brought about by them, were already known in ancient times (Galenos), it was only at the end of the 19th century that the collapse of the nasal alae was recognized as a passive mechanism obstructing the inspiratory air passages. Since surgical methods for treating this condition were not available at that time, various small gadgets to be introduced into the nasal vestibulum were invented for stabilising the alae. Among these, Feldbausch's nasal dilator was the best known. It was in use up to the middle of this century, but then became completely obsolete. The history of this chapter of rhinology is related primarily by means of literal quotations of the phrases with which the authors presented their devices and praised their virtues.

Germany↗