Of the great number of factors of importance in the technic of transplantation in ununited fractures of long bones, only four will be mentioned here:
The length of time which should elapse between the healing of a compound infected fracture and the time of transplantation.
A method of fixing a transplant in selected cases without screws, pins or suture.
The use of the periosteal-compacta transplant, or wafer graft.
The care of the hard ends of an old ununited fracture.
WHEN TO TRANSPLANT IN FORMERLY INFECTED WOUNDS
It is said that mild infection stimulates osteogenesis and thus favors repair; but the latent infection present in the majority of cases of healed compound ununited fractures threatens the success of transplantation. If it is not molested by trauma or operative interference, it generally gives no trouble and will remain latent even when it is situated within or extremely close to the operative field.
THOMAS HB. THE TREATMENT OF OLD, UNUNITED FRACTURES OF LONG BONES: WITH SPECIAL REFERENCE TO THE USE OF THE OSTEOPERIOSTEAL GRAFT. JAMA. 1923;80(5):309–315. doi:10.1001/jama.1923.02640320021009
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