[Plate osteosynthesis in the treatment of open femoral shaft fractures. Course in 65 cases].

In this study the results of 65 open femoral shaft fractures treated by plating are reported. The follow up of these cases proved that the osteosynthesis by plate is the treatment of choice in most of open femoral shaft fractures. The overall rate of postoperative complications was 23%. There were 5 deep infections concerning third-grade open fractures in two patients. In 10 cases a second operation was necessary because of delayed union; in 8 of these 10 fractures a homologous cancellous bone graft was performed during the first operation. Regarding to these complications an autologous bone transplantation should be carried out after primary plating of open femoral shaft fractures in order to improve vascularity and stability of the fracture. To reduce the unsatisfying rate of infections in III.-grade open fractures the treatment by external pin fixation in these cases should be preferred.