Severely comminuted femoral shaft fractures: treatment by bridging-plate osteosynthesis.

We report on 71 severely comminuted femoral shaft fractures that were operated on between 1980 and 1984 at the Berufsgenossenschaftliche Unfallklinik Duisburg-Buchholz. The method of operative stabilization was plate osteosynthesis in two variations: In one group 39 fractures (ten open) were stabilized by plate osteosynthesis after anatomical reduction of the fractured area. The other group comprised 32 fractures (six open) fixed with a bridging-plate osteosynthesis, without preparation of the fracture zone. The rate of postoperative complications was strikingly diminished after bridging-plate osteosynthesis. Fracture healing occurred within 23 (16-32) weeks after bridging-plate osteosynthesis and within 36 (32-40) weeks after anatomical reduction. No special instrumentation or equipment is necessary to perform a bridging-plate osteosynthesis. The patient rests in a supine position. There is no need for intraoperative image-intensifier control. For operative treatment of severely comminuted femoral fractures we consider the technique of bridging-plate osteosynthesis advantageous, especially in multiply injured patients.