[Primary stabilization of open fractures of the lower extremity with the interlocking nail--the results of a study of 91 patients].

The authors report on a series of open fractures (Type I and Type II) on the lower extremities of 91 patients, treated at the I. University Clinic of Traumatology, Vienna and at the Traumatologic Department of Wilhelminenspital, Vienna from 1975-1987. There were 25 open femoral- and 66 open tibial fractures. We have seen 60% Type I and 40% Type II fractures on the femur as well as on the tibia. 74% of the patients were male. The patients' ages ranged from 15 to 92 years with a median of 32 years. The main fracture type was the comminuted fracture with over 50%. In contrast to the references in the literature (9, 11, 21) we noticed an infection rate of only 1.2%. 96% of the operated and checked up patients received bone union with the interlocking nail. We cannot in any way attribute these results solely to the used implant. Conscientious indication in the application of the interlocking nail, an exact preoperative management with prophylactic antibiotic as well as an excellent operative technique are also taken into consideration. The choice of the static interlocking nail (73%) after the closed reduction (80%) of these open fractures is supposed to be a measure against infection. Due to these results we are of the opinion that the interlocking nail when selectively used in the hands of an expert can be recommended not only in closed fractures but also in Type I and II open fractures of the femur and the tibia as long as the special principles of treatment are not neglected.