Two step procedure and reosteosynthesis at the thigh. Definition and retrospective analysis

The change of treatment modality in osteosynthesis is based on two principl es. On one hand, one can exchange the implant as part of a two step procedu re to reduce side effects of stabilizing fractures. On the other hand, a re osteosynthesis may be required for treatment of complications. A retrospect ive analysis was undertaken to differentiate the situation of indication, t echnique and results of patients with fractures of the femur. Indications for two step procedure of therapy at the femur are limited to f ractures of polytraumatized patients and fractures with severe soft tissue damage. External fixator devices have been used for stabilization of long b one fractures with severe soft tissue damage using the two step procedure i n the past decades; nowadays unreamed nailing is commonly preferred. Reosteosynthesis may be appropriate for the treatment of failing of osteosy nthesis; they can also be used due to delayed union or nonunion of fracture s, osseous deficiency or infection. In the case of failing osteosynthesis, the reasons for failing have to be studied thoroughly and a variety of subs equent procedures has to be taken into consideration for successful treatme nt.