Abstract
The history of the first attempts at surgical treatment of fractures is much more complicated and interesting than reported until now. A fracture of the humerus treated by wire cerclage in 1775 is often mentioned as the first case of internal fixation.
However, a detailed analysis of original sources has revealed that this surgery has not been performed. The first and detailed description of internal fixation was published by the American surgeon John Kearny Rodgers in 1827.
It was used to treat a supracondylar non-union of the humeral shaft in a 15-year old boy, persisting for one year. French surgeon Achille-Cléophas Flaubert entered the history of internal fixation in 1838 when he treated a 21-year old woman with a non-union of the humerus by its resection and osteosuture with a non-specified material.
Several weeks later Flaubert successfully treated a 55-year old coachman who sustained an open fracture of the humerus. Probably the first to perform a successful internal fixation of the patella in the pre-antiseptic era was the American surgeon Thomas Maldrup Logan.
In 1864, he used this method in an inveterate fracture of the patella in a 30-year old man. The father of the intramedullary fixation may be considered Johann Friedrich Dieffenbach, a prominent German surgeon from Berlin, who used intramedullary ivory pegs to treat non-unions of the femur, tibia and humerus in 1846.
The first internal fixation of a fracture of the femoral neck by a percutaneously inserted nail was performed by German surgeon Bernhard Rudolf Konrad von Langenbeck in 1858.