Abstract
Gustilo type IIIb open fractures are most often associated with high energy trauma and cannot be closed by simple suture because of the high risk of infection and non-union. As an alternative to the external fixator, fixation by reamed locked intermedullary nailing was done according to the standard technique. The fixation allowed immediate partial or complete weightbearing and mobilisation of the neighbouring joints. In addition, it allows simple and rapid skin cover by flaps. This immediate skin cover allows one to diminish the risk of infection.
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