From 1982 to 1986, a total of 202 lower leg fractures (70 closed, 132 open fractures) were treated with a monoexternal fixation device, and 148 cases were included in the follow-up study. The mean healing time was 15.4 weeks for closed fractures and 18.4 weeks for open fractures. Infection was occurred in 3.4% of the patients followed up (5.1% open fractures, as 0% closed fractures), aseptic delayed in 8.8%, and pin tract infection in 2.5%. The group of patients with open fractures treated with additional lag screws (n = 74) showed a higher rate of refractures (10.9% vs 4.5%) and bone grafting (65.5% vs 29.5%) than the control group without lag screws (n = 58). The healing times (15.8% vs 15.5 weeks) and rates of non-union (10.9% vs 11.4%) were similar in both groups. Among 14 cases of secondary intramedullary nailing, osteitis occurred in 2. In the dynamized group (n = 53) healing time was reduced to 16.0 weeks, as against 18.0 weeks in the n-dynamized group (n = 95).