Osteomyelitis following surgical treatment of femoral shaft fractures. Results of a community study
Senst, W.; Meyer, H.
Zentralblatt für Chirurgie 111(3): 127-133
1986
ISSN/ISBN: 0044-409X PMID: 3962521 Document Number: 281277
A retrospective analysis was made of 3,280 diaphyseal femur fracture surgically treated in 73 medical centres of the GDR. The conclusion drawn from this quality check was that the high osteomyelitis rate of 5.6 per cent had been primarily attributable to shortcomings in osteosynthesis techniques but also to inadequate choice of methods. The following conclusions may be derived from the study reduction of bone infections: The osteomyelitis rate in the wake of Küntscher's nailing was as low as 2.2 per cent. This was the best result in the context of simple fractures with closed soft-part trauma. The advantages of covered intramedullary nailing were particularly felt in cases in which optimum protection against infection was impossible for the given surrounding conditions. Plate osteosynthesis has proved to be the most effective approach to open fractures, provided careful wound dressing, non-invasive surgical techniques, and generous indication in favour of autogenic spongiosa transplantation. Interlocked nailing is considered to be the optional technique of osteosynthesis to cope with comminuted fractures. External stabilisation is urgently indicated in cases of massive traumatisation of the femoral diaphysis in conjunction with severe open lesions of soft parts.