Abstract An analytical study of 91 open fractures treated during the period 1967–1973 has been presented. Fifty-three were treated conservatively, whereas 38 were managed by primary internal fixation. There were 12 cases of deep infection in the conservatively treated group (22.6 per cent), of which 4 had persistent infection in spite of adequate treatment. In contrast to this, the group treated by primary internal fixation showed 5 cases of deep infection (13.1 per cent). All of these healed after the implants were removed, following union of the fractures. Minor sequestrectomy was performed simultaneously in 3 of them. Analysis of the results showed poor results after 22.6 per cent of fractures with conservative treatment in contrast to 5.2 per cent in the group managed by primary internal fixation. It is felt that judicious application of primary internal fixation in injuries associated with severe soft-tissue damage or multiple fractures is of definite advantage to the patient.