[Primacy of soft tissue reconstruction in complicated tibial fracture--a new concept].

A total of 158 tibial shaft fractures with soft tissue injuries were treated from 1986 to 1990. In cases with type III open fractures, early reconstructive procedures with local or free flaps were carried out after radical debridement. After 12 months 95% of these fractures had healed. Postoperative infection occurred only in 4 (2.5%) of these 158 tibial shaft fractures with soft tissue damage. Before 1986, without these principles, the infection rate of type III open fractures was 17%.