[Change in procedure to reamed intramedullary nail in diaphyseal femoral fractures after stabilization with external fixator].

Due to the special pathophysiological condition of the polytraumatized patient, intramedullary nailing of the femur is not generally recommended. Fracture treatment by traction is not suitable because of the poor intensive care and the persisting instability. The external fixator is able to stabilize the fracture without additional burden to the patient. The stability is sufficient for the first set of treatment. Stabilization requires a changing procedure to an internal osteosynthesis. It is possible to reduce the danger of pin-tract infections with a differentiated concept. The principle of permanent drainage secures the healing of diaphyseal fractures of the femur. 43 diaphyseal femoral fractures were treated with a changing procedure from external fixator to reamed intramedullary nailing. In 1 case (2.3%) we saw an osteitis. The others healed without severe complications. The occurrence of complications depends on the time of the changing procedure.