[Complications of plate osteosynthesis of the femur shaft. An analysis of 199 femoral fractures].

From January 1982 to June 1987 a total of 189 patients with 199 fractures of the femoral shaft were treated by internal plate fixation. Aseptic complications were found in 41 osteosyntheses (20.5%) and were due variously to implant deficiencies (11%: loosening 2.5%, deformation 1.0%, implant fracture 7.5%), delayed union (3%), non-union (4.5%), axial deformities (2.5%) and differences in femoral length (5%). Septic complications were seen in 2.5%. There are three main ways of limiting the rate of aseptic complications: (1) restrictive indications for internal plate fixation or femoral shaft fractures; (2) a precise surgical technique taking account of local biomechanical and biological needs; and (3) generous application of bone grafting.