[Analysis of re-osteosynthesis in femur shaft fractures 1980 to 1989]

Between 1980 and 1989, 210 patients with 212 femoral shaft fractures were treated at our hospital, 191 patients with 193 fractures (91%) had a follow-up control. Of these 193 fractures only 16 required totally 26 (13.5%) reosteosynthesis, with AO-Switzerland performing 625 (14.5%) reosteosynthesis in the same period of time, with the methods of primary fracture care only varying inconsiderably. The different reasons for reinterventions were planned reosteosynthesis, malposition, delayed union and pseudoarthrosis, loose and broken implants and infection. In comparison with AO-Switzerland the main difference was that we had no case with malposition (AO-Switz. 20%) leading to reosteosynthesis. The early infection rate at our hospital was 0.9% (AO-Switz. 2.6%) in comparison to a late infection rate of 2.1% (AO 2.2%). The screw-plate osteosynthesis and reamed femur-nail have both proved to be safe methods for primary fracture care, whereas combined osteosynthesis (e.g. two plates/reamed femur-nail and a plate) has a high rate of reosteosynthesis and therefore should be avoided.