Displaced clavicle fractures in adolescents: facts, controversies, and current trends.

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Abstract

[Indexed for MEDLINE] 3. Orthop Traumatol Surg Res. 2026 Jul 17:104797. doi: 10.1016/j.otsr.2026.104797. Online ahead of print. French innovations that have become gold standards in Trauma: locked nails, percutaneous pelvic fixation using less invasive surgical approaches, and the induced membrane technique. Le Baron M(1), Rongieras F(2), Ehlinger M(3). Author information: (1)Département de chirurgie orthopédique et traumatologie, Hôpital Nord, APHM, Chemin des Bourrely, 13015, Marseille, France. Electronic address: marie.lebaron@ap-hm.fr. (2)Service de chirurgie orthopédique et traumatologique, Hôpital Edouard HERRIOT, CHU Lyon, 5 place Arsonval, 69003 Lyon, France; Laboratoire de Biomécanique des Chocs, UMR_9406, Université Gustave Eiffel, 25, avenue F. Mitterrand, case 24, 69675 Bron Cedex, France. (3)Service de chirurgie orthopédique et de traumatologie du membre inférieur, Hôpital de Hautepierre II, Hôpitaux universitaires de Strasbourg, 1 avenue Molière, 67098 Strasbourg cedex, France. Advances in anatomical, biomechanical and biological knowledge as well as technical advances in fixation devices and ancillary equipment have enabled precise treatments in trauma management. Locked intramedullary nails, minimally invasive pelvic techniques, and the induced membrane technique are examples of these French major innovations that have transformed that exemplify these advances. The locked intramedullary nail has revolutionized the management of long bone fractures by combining mechanical stability, while respecting bone biology, and thus allowing early mobilization. Modern nailing is based on three fundamental principles: a closed fracture site, reaming, and locking. Initially reserved for diaphyseal fractures, its indications have gradually expanded. Pelvic and acetabular surgery has simultaneously evolved significantly through the pioneering Letournel's work, which enabled a three-dimensional understanding of acetabular fractures and the standardization of classifications and surgical approaches. Advances in intraoperative imaging, specialized implants, and percutaneous techniques subsequently enabled the development of less invasive, more precise surgical techniques. Finally, Masquelet's induced membrane technique has established itself as the gold standard for the reconstruction of complex bone defects. This two-stage technique combines mechanical stabilization with biological induction through the formation of a vascularized membrane that promotes the integration of the bone graft. These three examples illustrate the major contribution of French surgeons to modern trauma surgery, combining the three fundamental principles of contemporary trauma surgery: mechanics, anatomy, and biology. LEVEL OF EVIDENCE: V; expert opinion. Copyright © 2026. Published by Elsevier Masson SAS. DOI: 10.1016/j.otsr.2026.104797