Progress in osteosynthesis techniques has enabled successful surgical stabilisation of femur fractures with multifragment and comminuted zones. Support plating, intramedullary nailing combined with cerclage wires, and interlocked nailing have proved to stand out as osteosynthesis methods for high stability. A retrospective study was conducted into 73 medical centres throughout the GDR to analyse the effectiveness of several variants of osteosynthesis in 939 adult patients who had received surgical treatment for femur fractures with severe traumatisation of the bone. Interlocked nailing proved to be unambiguously superior to other techniques for good results and low rates of complications. This analysis is likely to support current recommendations to the effect that interlocked nailing should be definitely preferred to cope with multifragment and comminuted femur fractures.