February 1976

Cortical Bone Healing After Internal Fixation and Infection: Biomechanics and Biology

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by W. W. Rittmann and S. M. Perren, 76 pp, illus, $27.90, Springer-Verlag, 1974.

Arch Surg. 1976;111(2):206. doi:10.1001/archsurg.1976.01360200112027

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This thin book is in actuality an experiment published in hard cover without editorial critique. The purpose of the experiment was to show that an osteotomy rigidly internally fixed will heal satisfactorily in the presence of gross sepsis. Adult sheep underwent diaphysial tibial osteotomies and internal fixation by one of three techniques: two dynamic compression (DCP) plates, one of which contained strain gauges to measure forces across the osteotomy site; one broad DCP plate; and one DCP plate not using compression and leaving a gap of 100 mμ.

Soft-tissue healing was allowed to proceed for six to eight days, after which time a large inoculum of living Staphylococcus aureus bacteria was instilled into the osteotomy site. These sites were tested periodically to ensure persistent infection. If tests proved negative, an S aureus inoculum was reinjected, and animals were weight-bearing very soon after surgery. The group with strain gauges were tested

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