French innovations that have become gold standards in Trauma: locked nails, percutaneous pelvic fixation using less invasive surgical approaches, and the induced membrane technique.

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.