[External fixation for open fractures of the femur]

32 cases of severe open fractures of the femur were treated by external fixation in 1 lateral plane with either the Wagner apparatus or the A.O. tubular system. 2/3 of the cases were war injuries and 1/3 were due to traffic accidents. In 1 case the broken limb was severely burned. In half the cases external fixation was changed for P.O.P. or internal fixation because of pin tract infection or delayed union. There were no non-unions or amputations, but 1 case had chronic post-traumatic osteomyelitis. We conclude that the method of choice for 3rd degree open fractures of the femur is external fixation. In the case of severe multitrauma and complex wounds with vascular injury or burns, external fixation is mandatory.