In order to cope with the frequent lack of adequate and sufficient external fixator systems in Third World countries, the pin-in-plaster technique was adopted and used in the management of open fractures of the femur. It consists of the use of Steinmann and Schanz pins incorporated into a plaster of Paris cast. The technique was successful in 13 of 15 open fracture cases treated at the University Teaching Hospital in Calabar (86.6). The advantages and disadvantages of the method are discussed. The method is recommended as an effective improvisation of the Hoffman apparatus for use in exceptional circumstances, such as war and adverse socioeconomic conditions as are found in most Third World countries.
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