Indications for operative fracture treatment in tropical countries

In the period 1 January 1987 to 30 June 1989, 3003 operations were performed at the regional hospital of Gbadolite, northern Zaire. In 123 patients fractures were reduced operatively, in 86 patients by internal fixation and in 37 patients by external fixation. There was no additional bone infection after external fixation but six of 28 patients (21%) with internal fixation by plate and screws developed postoperative osteitis. Non-union was observed in 12% after intramedullary nailing, in 4% after screw fixation alone, and 14% after internal fixation by Kirschner wires. Based on these data, indications and contraindications for operative fracture treatment in tropical countries are defined.