Abstract
From 1818 to 1931, foundations of the successful treatment of fractures of the proximal femur were laid. The initial contribution of the British school during the first half of the 19th century consisted of the first classification, first experiments on animals, detailed description of clinical symptoms and the morphologic features of different types of fractures (femoral neck fractures, trochanteric fractures), nonunions, and posttraumatic deformities, mainly on the basis of autopsy.
In the 1850s through the 1870s, German surgeons Volkmann, Trendelenburg, and König were the first to do internal fixation of fractures of the femoral neck, but the time was not ready yet for this method of treatment. In 1891, the Hungarian surgeon Dolinger was probably the first one to perform open reduction and internal fixation (wire cerclage) of the extracapsular fracture of the proximal femur.
In 1897-1899, the Norwegian surgeon Nicolaysen operated on a bigger group of patients, using radiograph both for preoperative diagnosis and for postoperative results control. The American surgical school was formed at the end of the 19th century and was based on the experiments of N.
Senn. The American orthopaedic and general surgeons were quite active and brought numerous new elements, e.g. the open method of internal fixation from different surgical approaches, new implants (nails, screws, bone and ivory pegs, external fixation, angled blade plate).
Despite unquestionable success in using internal fixation of fractures of the proximal femur as a standard method, their European contemporaries and outstanding personalities in the sphere of bone surgery, Lambotte, Delbet, Hey-Groves and Putti, failed to introduce the surgical treatment into general practice. They, however, inspired their successors.
Further technical progress (stainless steel, new technologies), development of anaesthesia and asepsis, improvement of x-ray apparatus, and introduction of a traction table only later on created prerequisites for a successful development of the American school in the form of the Smith-Petersen method during the 1920s.