Objectives : The purpose of this study was to evaluate the efficacy of external fixator as an interim mode of stabilization, converted to internal fixation and compare it to the role of external fixator as a definitive mode of stabilization, in the treatment of open comminuted fractures of femur.
Material and Methods : It is the retrospective analysis of 37 open comminuted fractures. The patients were treated with either ring fixator; dynamic axial fixator or the combination of the two, according to the type of fracture, general condition of patient and need for secondary soft tissue procedures. The debridement, impregnation of antibiotic mixed cement beads done primarily and periodically. The secondary procedures like internal bone transport, vascularized fibula graft, internal fixation was carried out.Results : The mean time of union, total duration of the fixator and rates of complications were evaluated. The mean time for union of fracture was shorter in the patients with open comminuted fractures treated with definitive external fixation compared to those treated by primary external fixator and converted later to internal fixator in comminuted fractures. There were fewer incidences of the knee stiffness and infection in the patients treated with definitive external fixator.Conclusion : The external fixator can be used as a definitive mode of stabilization in patients with open, comminuted fractures. It often facilitates, the often necessary secondary reconstructive procedures like bone transport and vascularized fibula graft.