[Experiences with plate fixation in 131 femoral shaft fractures]

A consecutive series of 131 comminuted fractures of the femur in 123 patients has been reviewed. All fractures were stabilized by means of rigid ASIF-plate fixation (mostly DCP). About 60% of the patients were polyfractured or polytraumatized (including brain, chest and abdominal injuries). In 85% of the cases the fracture was stabilized within 24 h after the accident and usually the patients remained on a ventilator with PEEP for 1 to 2 days postoperatively. Of the 4 postoperative deaths only two patients died of a pulmonary complication. All patients could be reexamined 1-3 years postoperatively. Although a number of them had suffered from complications (osteitis, fatigue fractures of the plate, delayed union) and had to be reoperated,92% of the cases displayed an excellent or good functionl result. The factors to reduce the complication rate(i.e. primary cancellous bonegraft) are being discussed.