Evolución histórica de las ideas en el tratamiento de fracturas trocantéricas

Laburpena

A review was performed of the various concepts, treatment strategies and osteosynthesis devices, since the first treaties about femoral fractures were published in the 16th Century, until today. Initially, it was poorly known and often confused with hip dislocations even until well into the 18th Century. In the following century surgeons strove into typifying the different fracture lines, thus relating these with their prognoses. The orthopedic treatment that the various schools defend, sometimes contradictory, and that was carried out until the onset of the 20th Century, caused a high incidence of secondary effects, and a very worrying percentage of mortality due to prolonged bed rest. In the 20th Century and thanks to improved aseptic and anesthetic techniques, surgical intervention was more widespread; nevertheless, it was not until the 1960s when surgical and emergency treatment of such fractures became the gold standard. Diverse types of osteosynthesis were developed, with four different stages being established: its beginnings, the monoblock nail-panel, dynamic osteosynthesis and lastly trochanteric nails. Progress in the development of new osteosynthesis—even minimum—is of great use and considerable importance, given the important repercussion of hip fractures.