Open fractures and internal fixation in a major African hospital

Between September 1992 and June 1994, 20 patients with 27 open fractures were treated at a major Ethiopian hospital by open reduction and internal fixation. Sixteen fractures were caused by gunshots, eight by road traffic accidents, two by direct blows, and one by a fall. Twenty-one fractures were stabilized with ASIF plates, and six with screws and wires. Five fractures out of 27 (18.5 per cent) developed infection postoperatively. In one case secondary wound infection subsided after wound excision and plate removal. In three others the implants were replaced by external fixators, in two of which the infection subsided and the patients left hospital without infection. The two remaining patients were treated for 4 1/2 months and 18 months respectively for chronic osteitis. Ten of the 15 patients without postoperative infection returned for follow-up. None of them had developed osteitis. The overall functional results were good.