Abstract Normal Blood Supply of Bone. Effect of a Fracture on the Adjacent Arterial Circulation. Effect of Cutting the Veins and Lymphatics at the Site of Fracture. Incompressibility of Muscle Tissue and the Effect of This on the Circulation of Blood to a Fracture Area. Relation of the New Bone Trabeculae to Blood Vessels. The Laying Down of Lime Salts. Development of Fibrous Tissue. Summary. Conclusions. In 1863, Hamilton1 estimated the incidence of nonunion of fractures to be one in 500 cases. Scudder and Hey-Groves,2 in 1927, placed it, respectively, at from 2 to 3 and from 3 to 5 per cent. If it is true, but this is doubtful, that there is a larger percentage of delayed unions and nonunion of fractures today than formerly, it may easily be accounted for by the greater traumatisms sustained today and by the more exacting standards under which the surgeon works, References 1. Hamilton, F. H.: A Practical Treatise on Fractures and Dislocations . Philadelphia, Blanchard and Lea, 1863, p. 61. 2. Bancroft, F. W., and Scudder, C. L.: The Treatment of Fractures , ed. 10, Philadelphia, W. B. Saunders Company, 1926, p. 949. 3. Koch, John C.: The Laws of Bone Architecture , Am. J. Anat. 21:177 ( (March) ) 1917.Crossref 4. Boyd, W. M.: Surgical Anatomy , Philadelphia, W. B. Saunders Company, 1925. 5. Johnson, R. W., Jr.: A Physiological Study of the Blood Supply of the Diaphysis , J. Bone & Joint Surg. 9:153 ( (Jan.) ) 1927. 6. Blaisdell, F. E., and Cowan, J. F.: Healing of Simple Fractures , Arch. Surg. 12:619 ( (March) ) 1926. 7. Gray, Henry; and Lewis, W. H.: Anatomy of the Human Body , Philadelphia, Lea & Febiger, ed. 21, 1924, p. 87. 8. Kolodny, A.: The Periosteal Blood Supply and Healing of Fractures , J. Bone & Joint Surg. 5:698 ( (Oct.) ) 1923. 9. Keen, W. W., and DaCosta, J. C.: Surgery, Its Principles and Practice , Philadelphia, W. B. Saunders Company, 1920, vol. 1, p. 418 10. vol. 2, p. 104 11. vol. 5, p. 165. 12. Eising, E. H.: Remarks of the Physiology of Bone in Relation to Bone Diseases , Am. J. Surg. 3:368, 1927. 13. Bancroft and Scudder (footnote 2, p. 927). 14. Wieder, Henry S.: Regeneration of Bone , Univ. Penn. M. Bull. , 1907, p. 33. 15. Tigerstedt, R.: A Testbook of Physiology , ed. 3, New York, D. Appleton & Co., 1906, p. 19. 16. Starling, E. H.: Principles of Human Physiology , ed. 4, Philadelphia, Lea & Febiger, 1926, p. 872. 17. Henderson, L. J., and Brink, F. N.: The Compressibilities of Gelatine and Solutions of Muscle , Am. J. Physiol. 21:248 ( (Feb.) ) 1908. 18. Todd, T. W., and Iler, D. H.: The Phenomena of Early Stages of Bone Repair , Ann. Surg. 86:715, 1927. 19. Delafield, Francis, and Prudden, T. M.: A Textbook of Pathology , ed. 12, New York, William Wood & Company, 1923, p. 1059. 20. Arey, L. B.: The Origin, Growth and Fate of Osteoclasts and Their Relation to Bone Absorption , Am. J. Anat. 26: 315, 1919-1920. 21. Watt, J. C.: Deposition of Calcium Salts in Areas of Calcification , Arch. Surg. 10:990 ( (May) ) 1925. 22. Bancroft, F. W.: Bone Repair Following Injury and Infection , Arch. Surg. 5:646 ( (Nov.) ) 1922. 23. Ely, L. W.: Experimental Study of the Healing of Fractures , Arch. Surg. 5:527 ( (Nov.) ) 1922. 24. White, J. R.: Chronic Traumatic Osteomyelitis , New York, Paul B. Hoeber, 1919, p. 28. 25. King, H. W., and Wisler, C. O.: Hydraulics , New York, John Wiley & Sons, 1922, p. 7.
Archives of Surgery – American Medical Association
Published: Sep 1, 1928
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