Surgical fracture treatment has undergone an extensive evolution in the past decades. In the early days achieving solid healing in anatomically reduced position was the primary and nearly exclusive goal of fracture treatment. Since mainly Lambotte, Danis and Müller in Europe the focus of surgical fracture treatment shifted to achieving early recovery of the function of the injured limb with safe healing. Considering the shortcomings of the early fracture treatment helps understanding the evolution of surgical fracture treatment. The evolution of the biomechanical and biological principles of AO plate fixation are discussed as a model.