Otto Hilgenfeldt (1900-1983): tribute to an important pioneer of European hand surgery.

The German surgeon Otto Hilgenfeldt (1900-1983) was a great innovator in European hand surgery in the 20th century, particularly in respect of the tactile (sensate) thumb and grip reconstruction in amputation injuries. His experience, beginning in the 1930s, helped him to treat hundreds of soldiers with mutilating hand injuries from 1941 to 1945 during World War II. While totally isolated and without any access to international publications, he devised many innovative ideas such as a neurovascular middle finger transposition for pollicization (first case done in July 1943) and a sensory dorsoradial first metacarpal flap for thumb resurfacing. His book Operative thumb replacement and substitution of finger losses published in 1950 is regarded as one of the most important German contributions to modern hand surgery. Hilgenfeldt's life and work remain fascinating and exemplary from a historical and surgical point of view. Many of his pragmatic surgical solutions remain valid despite the advent of microsurgery.