ABSTRACT
Se presenta la evolución histórica y científica de la osteosíntesis de huesos largos realizada con clavos rígidos. Mediante una revisión bibliográfica retrospectiva en revistas de Traumatología nacionales y extranjeras, así como libros relevantes de esta especialidad, se pudieron establecer tres momentos claves en la osteosíntesis intramedular con clavos rígidos y caracterizar las diferentes generaciones que aportaron a este procedimiento en la historia de la Ortopedia y la Traumatología. Destacan las innovaciones tecnológicas incorporadas a la práctica quirúrgica y el desarrollo de biomateriales para mejorar la reparación de lesiones e incorporar al paciente a su vida cotidiana. El trabajo demuestra cómo ha avanzado la técnica quirúrgica de fijación intramedular y la consolidación ósea; y gracias a ello los problemas de las fracturas han quedado prácticamente solucionados.
The historical and scientific evolution of osteosynthesis of long bones performed with rigid nails is presented. Through a retrospective bibliographic review in national and foreign Traumatology journals, as well as relevant books of this specialty, it was possible to establish three key moments in intramedullary osteosynthesis with rigid nails and characterize the different generations that contributed to this procedure in the history of Orthopedics and Traumatology. The technological innovations incorporated into surgical practice and the development of biomaterials to improve the repair of injuries and incorporate the patient into their daily lives stand out. The work demonstrates how the surgical technique of intramedullary fixation and bone consolidation has advanced; and how thanks to this the problems of fractures have been practically solved.
ABSTRACT
BACKGROUND: Nearly 80 years ago in the autumn of 1939 Gerhard Küntscher successfully stabilized a patient with the first intramedullary nailing surgery. As a result, the research interest in osteosynthesis significantly increased. OBJECTIVE: Many important studies referencing Küntscher and his invention have been published over the last decades focusing particularly on the alleged individual performance of the surgeon. The present study highlights the close collaboration between Küntscher and the engineer Ernst Pohl, which developed an enormous creative energy and power. At the same time the intramedullary nail itself is at the center of attention. Despite a harsh critique especially in the first years of its existence this idea quickly spread around the world of trauma surgery. This article gives a retrospective view of which factors promoted its spread and which were barriers. MATERIAL AND METHODS: In this study articles on medical history were taken into consideration as well as the medical specialist literature. In addition personal letters, memoirs and other individual written sources from relevant players were consulted to allow for a change of perspective. The latter were fundamental for this study. RESULTS AND CONCLUSION: The study showed the eminent impact that the close cooperation between Küntscher and Pohl had on the success of the intramedullary nail. The synergy of Küntscher's medical expertise and Pohl's ingenuity found solutions for problems other people could not solve. World War II interrupted this close interaction but at the same time helped to disseminate the technique globally which in turn contributed to the advancement of the idea.
Subject(s)
Bone Nails , Fracture Fixation, Intramedullary , Fracture Fixation, Internal , Humans , Retrospective Studies , SurgeonsABSTRACT
PURPOSE: This paper provides for the first time an overview of orthopaedic surgeons nominated for the Nobel Prize in physiology or medicine during the first six decades of the twentieth century. The study is part of the project "Enacting Excellency: Nobel Prize nominations for surgeons 1901-1960". METHODS: The nomination letters were gathered in the archive of the Nobel Committee at the Karolinska Institute in Solna, Sweden. RESULTS: Among the nominees, we find renowned scholars like Pierre Delbet, Themistocles Gluck, Gerhard Küntscher, Adolf Lorenz, Friedrich Pauwels, Leslie Rush, and Marius Smith-Petersen. The focus of the paper is on nominations for Pauwels (work on biomechanics) and Küntscher (the Küntscher nail). Both were nominated by German surgeons. CONCLUSIONS: Although no orthopaedic surgeon has yet received a Nobel Prize for an orthopaedic achievement, Nobel archive files can help reconstruct important trends in the field during the twentieth century.
Subject(s)
Orthopedic Procedures/history , Orthopedics/history , History, 20th Century , Humans , Nobel Prize , SwedenABSTRACT
In the last part of the nineteenth century and beginning of the twentieth century surgeons at the University of Vienna helped transform the practice of surgery. They developed new more effective procedures, analyzed the results of their operations, promoted the emergence and growth of surgical specialties and sought understanding of tissue structure, physiology and pathophysiology. Their efforts made Vienna one of the world's most respected centres for operative treatment, basic and clinical research and surgical education. Two individuals, Adolf Lorenz (1854-1946) and Lorenz Böhler (1885-1973) focused their research and clinical practice on orthopaedics. During the same period in Germany Friedrich Pauwels (1885-1980) founded an orthopaedic institute and an engineering workshop in Aachen in 1913 and rapidly developed a lifelong interest in biomechanical influences: Using these theories, he achieved in 1927 healing of a non-union of the femoral neck by a re-orientation osteotomy, a condition considered to be incurable until this osteotomy and created his famous classification of fracture angles at the hip into Pauwels types I, II and III. The German orthopaedist Gerhard Küntscher (1900-1972) remained the most popular surgeon after the second war with his famous nail.
