title: External fixation of open femoral shaft fractures.
abstract: OBJECTIVE
  To determine whether external fixation proves to be a sensible technique for definitive stabilization in open femoral fractures.
  
  
  METHODS
  Retrospective clinical study.
  
  
  METHODS
  From 1985 to 1989, 18 patients (mean ISS 25.4) with open femoral fractures (type II 11%, type III 89%) were treated by primary and definitive external fixation. After failure of closed reduction procedures, open reduction via debrided soft tissue wounds was employed in 72%. Supplemental internal fixation of large wedge fragments was required in 66%. External fixators were removed after a mean of 166 days. Early deep infections developed in 11%. Additional cast, brace, or traction were not required.
  
  
  RESULTS
  After a mean follow-up period of 58 months, 88% of the surviving 17 patients were clinically and radiologically evaluated and 12% were interviewed by telephone. Eleven percent developed late deep infection of the femur concerned. Eighty percent have had full or slightly restricted knee motion. The mean knee flexion amounted to 130 degrees. Relevant shortening of the femur was diagnosed in 7%. Nonunions or relevant malunions were not observed in our series.
  
  
  CONCLUSIONS
  These morphologic and functional results compare with those published for alternative stabilization techniques of femoral fractures. For special indications, external fixation is considered to be a sensible technique for primary and definitive treatment of open femoral fractures.
authors.affiliation: Department of Traumatology and Burn Medicine, Central Military Hospital of the German Federal Armed Forces, Koblenz.
authors.forename: V D
authors.initials: VD
authors.lastname: Mohr
authors.forename: U
authors.initials: U
authors.lastname: Eickhoff
authors.forename: R
authors.initials: R
authors.lastname: Haaker
authors.forename: H L
authors.initials: HL
authors.lastname: Klammer
mesh_terms: D000293:Adolescent; D000328:Adult; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005592:Fracture Fixation; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome