Bone transplantation as a treatment of Pott's disease, club feet and ununited fractures / by Fred H. Albee.

  • Albee, Fred H. (Fred Houdlett), 1876-1945.
Date:
[1912]
Catalogue details

Licence: In copyright

Credit: Bone transplantation as a treatment of Pott's disease, club feet and ununited fractures / by Fred H. Albee. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Number 11 Kausch, Marchand, Barth, Frankenstein and others bone trans- planted into bone persists and lives as such. Others, among whom are Axhausen, Murphy and Steida hold that bone with transplanted in the same individual and in contact with other living bone at one or both ends of the transplanted fragment, always becomes united to the living fragments and acts as a scaffolding for the reproduction of new bo’ne of the same size and shape as the transplanted fragment, if asepsis is attained. It is claimed that, the role the transplant plays is to give mechanical support to the capillaries and blood vessels with their living osteogenetic cells, as they advance from the living bone at both ends of the transplanted fragment, into the Haversian canals, canaliculi and lacunae of the transplant. New lamellae are deposited around the capillaries and these lamellae fit into and adjust themselves in the graft, so that the bony union is actually formed and mechanical support given long before the transplant loses its splint action and is replaced by new bone or, in other words the bone graft is per se not osteogenetic but osteo-conductive. Now as far as our purposes are concerned, it is readily seen, that it makes no difference, which of these contentions is true. A permanent supporting bone splint is obtained in either event. The accepted requirement for a bone graft is that it has con- tact with a recipient bone on one end. In the case of our trans- plant there are two bony contacts for each vertebras into which it is inserted. When inserted into three or four vertebrae, it has six or eight bony contacts. The bed into which a transplant is placed has apparently everything to do with its fate. In reference to this, we quote again from Murphy “ Bone with its periosteum transplanted into muscle fat etc., in the same in- dividual, and free from bony contact, practically always dies and is absorbed, except in the case of very young children or infants.” • It will be seen by this, that grafts placed beside and outside of the spinous processes in the soft tissues, in imitation of Langes metal splints, are not trustworthy. The writer wishes to state, here and will refer to it again, that he has become convinced from his experience with the herein reported treatment of Pott’s disease and a large amount of animal experimentation, that the exact environment of bone graft, even when it is inserted into or in contact with a recipient bone