By PD. Dr. med. W.W. Rittmann, PD. Dr. med. S.M. Perren (auth.)

The possibility of an infection continues to be the main severe difficulty to inner fixation. Prevention, utilizing all to be had prophylactic measures will be the relevant function in each surgical division. although the an infection cost may well stay less than the suitable point of two percent, the contaminated sufferer derives little convenience from the massive variety of very good leads to people. We needs to notice how one can supply those sufferers a beneficial diagnosis. this could no longer be in accordance with instinct yet on transparent confirmed guiding ideas. making plans the remedy for a sufferer whose inner fixation has develop into septic needs to make a decision among steps that can have benefits or disadvan­ tages. the drawback of the presence of a international physique needs to be weighed opposed to the good thing about stress. The authors have taken up this problem via deliberate animal experiments to check the therapeutic of internally fastened fractures which were contaminated with staphylococci. they've got proven that below good stipulations, even large an infection didn't spoil the therapeutic procedure 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

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40). The inner layers were rather dense and appeared nonoriented or, in places, of a radial configuration. The outer layers were more spongy. In many cases a clear orientation in layers was typical in the peripheral zones. The area of final bridging was often clearly visible over the osteotomy. The contact between callus and cortex was planiform and in places the callus was anchored plug-like in the outer cortical layers, best observed on fluorescent microscopic examination (Fig. 43). In the area of the fragment ends the periosteal callus grew into the plane between the fragments (Fig.

Most frequently contact healing of one cortex was present with simultaneous gap healing on the opposite side of the bone circumference. '--_-', 0,1 mm Fig. 56. Haversian remodelling in sheep 2665 (group " compression with one plate " ): Maximal remodelling activity was found in most cases during the fifth and sixth week little and occurred late towards the end of the experiments (Fig. 57). Contact healing: On rare occasions osteons reached the osteotomy accompanied by vessels filled with ink ; even more seldom they crossed the osteotomy (Fig.

On the opposite side extensive sequestration of the entire osteotomy 14 covered by incomplete callus bridging. Endosteal union of the fragment ends by callus. Therefore, this case will not be classified as union of the mary type of bone healing. J 0,1 mm Fig. 60. Gap healing of the infected osteotomy of a sheep: In the fifth and sixth week the gap between the fragment ends was filled with lamellar bone oriented in transverse direction .

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