[Treatment of the open tibial fracture with the fixateur externe with special reference to osteosynthesis of the fibula].

In the treatment of open fractures of the lower limb and of fractures combined with severe damage of soft tissues, external fixation is favoured. Additional soft tissue damages in the compartments of the lower limb are avoided by using an external fixation in form of a clamp. In defect fractures, shattered fractures and in all fractures in the distal third the stability of clamp fixation is enhanced by plating of the fibula. Furthermore by osteosynthesis the reconstruction of the correct length of the lower limb can be performed. 36 fractures healed definitively in an average of 17.1 weeks by this procedure. Secondary procedures were: 8 cases with decompression of compartments, 11 cancellous bone grafts, 13 fixateur externes were removed because of the infection of the Schanz'screws, and healing was achieved by using a plaster cast. The therapeutical procedure was changed in 5 patients to a plate osteosynthesis and in 8 patients to an intramedullary nail.