Complication rate of long bone fractures treated by early stable internal and trans-osseous osteosynthesis

Complications occurring in 94 (24.1%) of 390 operative osteisynthesis were analysed. There were 284 patients with composite (115) and combined fractures of long bones. Complications occurred during recovery in 54 (23.6%) cases of transosseous osteosynthesis and in 40 (24.8%) cases of internal osteosynthesis. Intra-operative complications occurred in 4 cases due to technical errors, e.g. further comminution or vascular injury. Postoperative complications occurred in 7 cases due to inappropriate choice of fixation device, e.g. loss of reduction or fication failure. Postoperative infections predominantly involved the femur and tibia (60.6%). The final outcome was not influenced by local pin tract infection involving either skin, bone or both. There were 15 cases with general complications, e.g. pneumonia, thromboembolism, and decubiti; and 12 with local complications, e.g. toxidermia and marginal wound necrosis. All general complications were associated with restricted patient mobility and were observed 3 times more frequently (6.2%) with internal osteosynthesis than with transosseous osteosynthesis (2.2%). Careful attention to technique will help minimize the complication rate of osteosynthesis.