A biography of the point contact fixator (PC-Fix)

Starting in the mid-eighties, the AO (from the German "Arbeitsgemeinschaft für Osteosynthesefragen") Research Institute (ARI), Davos, Switzerland together with the commercial partners of the AO Foundation embarked on a decade-long project to design, develop, test in experimental animals and human clinical trials as well as bring to clinical use a new system for surgical osteosynthesis. The new plating system, what became known as the Point Contact Fixator (PC-Fix), addressed the shortcomings of the conventional plating by Dynamic Compression Plate (DCP) discovered either by careful examination of the clinical complications or by chance observation and informed inquiry in experimental animals. The focus was on avoiding iatrogenic damage to bone vascularisation caused by the implant design and mechanical function and, thus, aiding efforts of surgeons to preserve vital bone tissue needed for healing. Infections have been and will remain a great concern in all surgery. Preservation of blood perfusion of traumatised bone is of paramount importance to reduce the risk of infection, especially in view of the emergence and the accelerated spread of bacterial resistance to antibiotics. Prof. Stephan Perren led this project in all its stages with his unique insight and wisdom. Unfortunately, due to the complex interplay of factors guiding the interests of the AO Foundation and its commercial partners, the findings of the PC-Fix project became watered down with implant systems that followed the DCP. The message of "keep the perfusion" faded into "lock the screws". The potential benefits of PC-Fix have been lost for millions of trauma patients.