By PD. Dr. med. W.W. Rittmann, PD. Dr. med. S.M. Perren (auth.)
The possibility of an infection continues to be the main critical situation to inner fixation. Prevention, utilizing all to be had prophylactic measures may be the vital function in each surgical division. although the an infection cost may perhaps stay lower 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 detect the way to supply those sufferers a beneficial analysis. this could no longer be in keeping with instinct yet on transparent confirmed guiding rules. making plans the therapy for a sufferer whose inner fixation has develop into septic needs to come to a decision among steps which could 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 by way of deliberate animal experiments to review the therapeutic of internally mounted fractures which were contaminated with staphylococci. they've got proven that below good stipulations, even vast an infection didn't ruin the therapeutic technique in cortical bone. Even below those situations fracture union, within the type of fundamental bone therapeutic, can take place whether with much less regularity than in unin fected inner fixation.
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Extra info for Cortical Bone Healing after Internal Fixation and Infection: Biomechanics and Biology
Fig. 34. Schematic plot of the periods of equal charge with both hindlegs (group "no compression with one plate"): Full weight bearing was most commonly started in the sixth week. Three sheep began again to non-weight bear after an initial phase of full weight bearing. 6. X-Rays: Plain Films (Table 16) The independent evaluations of the X-rays by six different examiners showed good conformity. There existed only minor time-differences in regard to the first appearance of a sign; that is, a finding may have been recognised or described by one examiner only on the X-ray following (two weeks later) the X-rayon which it was initially recognised by the other examiners.
We therefore contented ourselves with defining the pattern of bony union after eight weeks, without implying that the fracture was completely healed. We distinguish thereby the following patterns of bony union: ~ Healing by primary intention: No periosteal instability callus and only minimal fixation callus; no round edges of the fragment ends or osteotomy gaps. ~ Healing by secondary intention: Much callus, uneven structure, widening of the osteotomy gap. ~ No union: No sign of bony union between the fragments.
ELASTIC BENDING FORCE 6-HOLE PLATE IMPLANT. jJ kp EXPLANT. kp jJ 739 -50 7 0 0 1297 -15 2 -33 5 878 -72 11 -45 7 741 -58 8 -53 6 15 -25 4 -18 2 821 -80 12 -76 10 16 -100 15 -48 7 2287 -56 8 -30 4 II II II II 1/ II II II II II ELASTIC BENDING FORCE 4-HOLE PLATE IMPLANT. EXPLANT. kp jJ kp jJ 0 0 0 0 0 0 0 0 0 0 +59 8 -63 7 -22 2 -20 3 -5 1 -8 1 -25 3 -5 1 -12 2 -25 3 +15 2 29 Table 12. Zero shift during the experimental period: Determination of the zero-point at explantation shows good correlation with the values at implantation, when the changes in resistance due to the shortening of the electrical wires at explantation are considered.