Purpose: The aim of this study is the evaluation of the use of plate and screws without restoration of the opposite cortex and without the use of bone graft in the treatment of multifragmentary fractures of femur.

Material and Methods: For this purpose, we retrospectively studied 26 multifragmentary femoral fractures that were treated in our department in accordance with the above principles, between 1992 and 2001. All fractures were reduced indirectly with traction on the fracture table without any direct manipulation at the comminution zone. Emphasis was given to the restoration of the proper length, axial and rotational alignment of each fracture. The fixation was done with a long bridge plate, without the use of interfragmentary screws.

Twenty five of the fractures (96.5%) united, without any serious complication, within 3–5 months. In one fracture the fixation failed and had to be revised.

Conclusions: The use of plate and screws in the treatment of multifragmentary fractures of femur, once it is done with complete respect to the fracture biology leads to speedy fracture union, high union rate and a very low complication rate.