During the past 10 years, 471 free autoplastic bone transplantations were carried out in Hohenlychen. Recent research results clearly showed that apart from the osteoplastic activity, a metaplastic formation of new bone occurs in the tissue. The newly formed bone trabeculae between transplant and old bone begin to connect with those formed in the osteoid tissue in the seventh week, and in this way constitute the bone connection between the graft and the original bone which have completely grown together in the ninth week. After the twelfth week no old bone can be detected in the entire region of the original graft, but only new bone trabecula. The question of the ever present hematoma can be answered in this way: a blood extravasation, lying in the gap between the transplant and the old bone, and not being subject to pressure, represents an adequate stimulation to the mesenchymal germinal tissue formation, while the large hemorrhage represents a negative stimulation and permits only a scarry connection of the transplant and the defective stump. The periosteum is no more important than the other layers, it is transplanted with the bone, because in connection with the bone it has osteogenetic properties, but above all it effects a speedy supply from the surroundings. A careful technique must be employed to spare the tissue layers, and bleeding must be stanched. Foreign bodies in the shape of wire slings to hold the transplant usually heal well into the body. Firm fixation in a plaster cast safeguards the result. When the graft has taken, a careful start with remedial exercises may be made in the third or fourth month. The clinical use of free bone transplantations is discussed with the help of numerous examples and many X-ray illustrations. The first task of the bone transplant to bridge over a gap in the bone is to provide sufficient support for the defective stump and, therefore, it has to be fairly strong. Bone splinters in the lower arm have roentgenologically completely taken after 1-1½ years, those in the tibia after 1½-2 years. The free bone transplant, some distance from the joints, has proved to be particularly valuable with the usual dislocations of the shoulder and the hip joints. The overlapping bone ridge prevents the bone from coming out of the articular cavity. In the course of years, the piece lying in the soft parts is considerably reduced, so that only a small bone ridge remains. The graft effects a regeneration of the damaged edge of the articular cavity and in this way prevents further dislocation. Bone transplants in bone gaps after removal of growths are subject to special conditions of taking. Hyperemic phenomena in the zone of the tumor edge in the form of a mild inflammation, possibly also fermentation processes, accelerate the taking of the transplant compared with the process in healthy tissue. Increased local resorption processes, occasionally with spontaneous fractures, infrequently prevail, but they again are apt to heal well. In wounds which heal with difficulty owing to suppurative inflammations, there is a great danger of the transplant being pushed out. When the whole transplant region is inflamed, total sequestration cannot be stopped. If suppuration remains localized, partial sequestration of the transplantation must be awaited. (German Surgical Journal, 1944, Vol. 299, H. 9-12. H. Floercken-Frankfurt am Main.)
TRANSLATION OF GEBHARDT, FISCHER, OBERHEUSER
DOCUMENT 21
GEBHARDT, FISCHER, OBERHEUSER DEFENSE
EXHIBIT 20
EXTRACTS FROM AFFIDAVIT OF DR. KARL FRIEDRICH BRUNNER, 14 MARCH 1943, CONCERNING SCIENTIFIC EXPERIMENTS CONDUCTED AT THE CLINIC OF HOHENLYCHEN
I can state the following regarding the scientific experiments at the clinic [of Hohenlychen]: It was in accordance with the principles of the clinic and, therefore, of the chief and his deputy to collect scientific results arrived at through clinical observations. All reports at congresses and lectures as well as publications were based on these results. The scientific work and research were normally determined by the observations made on the patients. In addition to this, and in order to clarify the question of surgical treatment of nerve injuries, experiments on dogs were carried out in close collaboration with Gebhardt—first by Dr. Koestler in 1939-40, later by myself from 1943 to the end of the war. I was ordered by Dr. Gebhardt to carry out the experiments on animals at the training and experimental station for dogs [Hundelehr- und Versuchsanstalt], which establishment was situated outside the concentration camp Ravensbrueck, and I was strictly cautioned not to enter into any kind of contact with the concentration camp itself. The animal experiments were strictly continued until the end of the war. The results were never published because of war conditions.
Regarding Dr. Stumpfegger, I can state that he was an assistant of the clinic in peacetime, before I arrived. At the outbreak of war in 1939 he joined the Waffen SS, and was then, as far as I know, from 1942 onwards an escorting physician of Himmler. I did not see Dr. Stumpfegger on my return to Hohenlychen in autumn 1943, nor had he any official connection with the clinic up to the end of the war, either in a medical or in a military sense. He did not have to report his return or departure to the chief physician or to his deputy. His family, however, still lived at Hohenlychen. I still met him occasionally outside the medical sphere. I emphasize that during my presence at the clinic from 1 September 1943 up to the end of the war, as far as I know—and finally I was directing the clinic—no assistant was drafted from Hohenlychen to Ravensbrueck.