Küntscher – A historical vignette

Abstract

His life storyGerhard Ku¨ntscher was born on 1 December 1900 in Zwickau (Germany). Generally, he is regarded as the father of intramedullary locked nailing and as the developer of intramedullary osteosynthesis. On 9 November 1939, he performed the first procedure at the ''Chirurgische Klinik'' in Kiel (Germany); in March 1940, he presented the results of 11 femur nails as well as one forearm and one humerus nail at the Congress of the German Surgical Society in Berlin. The announcement of his innovative method led to a generally hostile discussion amongst Germany's pre-eminent surgeons. Only his chief AW Fischer took Ku¨ntscher's side and supported him. In December 1939, Ku¨ntscher was granted with the industrial property rights for intramedullary nailing. In 1941, he reported for duty at the eastern front where he worked in main dressing stations and in battlefield hospitals.In 1942, after a meeting of the Supreme Army Command in Krasnodar, intramedullary nailing of the femur was introduced to the German army due to the advice of Sauerbruch, Handloser, Frey, Bo¨hler and Wachsmut. In 1943, Ku¨ntscher was detached to the German military hospital in Kemi (Finnland) where he served as a consulting surgeon till 1944 (Cross, 2001).In 1945, Kuntscher returned to Germany. Unable to work in Kiel, he went to Schleswig-Hesterberg where he was treated for diphtheria for several months (Ratschko and Mehs, 2011). In the same year, the book ''Technik der Marknagelung'', written by Ku¨ntscher and Richard Maatz, a surgery resident at the

A review and critical analysis of the history of intramedullary nailing

“…He was the son of a factory director and consequently had significant early exposure to material science. He graduated from medical school in Germany in 1926 and, in 1936, published his thesis on the flow of forces within bones in which he coined the term “intramedullary nail” in German—“Marknagel.” 9 Many of the principles that would guide his work on IMN for several decades can be found in this thesis 10 . Based on his experience with the Smith-Petersen nail, Küntscher concluded that an IM construct would be optimal for diaphyseal fractures.…”

Intramedullary nailing biomechanics: Evolution and challenges

“…Although there is a considerable controversy in awarding a particular researcher's role along the history of intramedullary nailing evolution, it is generally accepted that Gerhard Ku¨ntscher -a German physician known as the 'founder of modern intramedullary nail'-had a significant impact on the designs and surgical techniques associated with intramedullary nailing. 41 During the World War II, Ku¨ntscher presented his pioneer concept, which he named 'marrow nailing', through a V-shaped (triangular in cross section) corrosion-resistant V2A stainless steel intramedullary nail 42,43 (see and 4(b)). 5,6,43,44 Both nails were developed for the treatment of femoral fractures and were inserted through an antegrade method at a fracture site distant location which guaranteed no disturbance to the injured region.…”

“…Although there is a considerable controversy in awarding a particular researcher’s role along the history of intramedullary nailing evolution, it is generally accepted that Gerhard Küntscher – a German physician known as the ‘founder of modern intramedullary nail’– had a significant impact on the designs and surgical techniques associated with intramedullary nailing. 41…”

Endomedullary Rods in Long Bones: A Danger Aboard

“…2 This splint can bend or break at any time, becoming stuck in the endomedullary channel and therefore difficult to remove. German surgeon Gerhard Bruno Küntscher 3 became aware of these drawbacks, observing that "…rupture of an endomedullary rod is explainable as a fatigue crack in the place of less resistance [in Latin aka 'locus minoris resistentiae'] located about at the fracture site, where the nail is not supported by the bone cylinder…. A nail can rupture not only due to a fatigue rupture but also through a chemical process, namely corrosion crack oscillation….…”