By PD. Dr. med. W.W. Rittmann, PD. Dr. med. S.M. Perren (auth.)
The probability of an infection continues to be the main severe challenge to inner fixation. Prevention, utilizing all to be had prophylactic measures can be the primary characteristic in each surgical division. notwithstanding the an infection expense might stay under the suitable point of two percent, the contaminated sufferer derives little convenience from the massive variety of first-class ends up in other folks. We needs to become aware of how you can provide those sufferers a beneficial diagnosis. this could now not be in line with instinct yet on transparent confirmed guiding rules. making plans the therapy for a sufferer whose inner fixation has turn into septic needs to make a decision among steps that can have merits or disadvan tages. the downside of the presence of a international physique has to be weighed opposed to the good thing about pressure. The authors have taken up this problem through deliberate animal experiments to review the therapeutic of internally mounted fractures which were contaminated with staphylococci. they've got proven that lower than solid stipulations, even gigantic an infection didn't wreck the therapeutic technique in cortical bone. Even below those situations fracture union, within the type of basic bone therapeutic, can ensue whether with much less regularity than in unin fected inner fixation.
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Additional resources for Cortical Bone Healing after Internal Fixation and Infection: Biomechanics and Biology
The osteons were 58 Sheep: 2287 1297, 15 13 Contact healing of both cortices on longitudinal cuts. Only slight resorption. Minimal callus formation . In one cortex the elements of gap healing are seen; on the opposite side characteristics of contact healing with or without "goccie di cera". Resorptive processes of min of extent yet causing an intracortical cavity on the side with contact healing in sheep 15 (Fig. 62). Little callus formation . See footnote on p. 57. _~IO,lmm Fig. 57. New bone formation around osteolytic focus: Deposition of new bone on fragment ends occurred predominantly in the eighth week (red-brown = alizarin complex one, emerald-green = no label).
Lamellar bone filling the spaces was oriented transversely and was formed independently of the remodelling of bone within the cortex. This can best be seen on microradiographic studies (see p. 52, Fig. 44). In the fifth and seventh week, filling of the gaps was most active (Fig. 60). In a few cases intracortical osteons had begun to cross these gaps in the longitudinal direction towards the end of the experiments (Fig. 61). We shall henceforth examine each sheep in each group separately with respect to the histological changes previously described.
38 . , 00 r-- 48 Group "compression with two gauge plates": Sheep 739, 878, 821 and 16 show a secondary healing pattern on X-ray examination (Faxitron). Bony union is uncertain in sheep 739. The adjacent micro radiographs are in good agreement with the X-rays except for that of sheep 878, in which there is no bony union seen in this section. Microtome cuts from other locations of the bone circumference show conclusively that bony union by callus apposition has occurred (see index picture of Fig.