[Secondary plate osteosynthesis of open fractures of the lower extremity--still a therapeutic alternative!?].

During the time period from May 1, 1990 to July 31, 1993, a total of 102 tibial and 144 femur fractures were treated in the Department of Traumatology of the University of Bonn. 45 patients with 25 open tibial and 22 open femur fractures were treated according to a regimen including primary stabilization, usually in an external fixator, soft tissue reconstruction and delayed open reduction and internal fixation using an A0-plate. A majority of the patients were involved in motor vehicle accidents, leading to multiple injuries in 26 instances. The complication rate of 17% is comparable to the reports following intramedullary stabilization. Only three chronic infections, following one grade two open femur fracture, one grade two and one grade three open tibial fracture, were seen. Bony union was achieved after 24 weeks. It is shown that the use of the A0-plate in the treatment of open fractures of the femur and tibia offers not only logistic advantages but represents a viable alternative for the delayed stabilization of these injuries.