. A practical treatise on fractures and dislocations. lamella? which lie upon the inner side of the compact new lamelhe extend across the canal, soon occluding it also out into the interval to meet those coming from the otherfragment. Thus is formed the internal or medullary plug. The granulations occupying the annular interval between the corticallayers of the two fragments (when the reduction is complete) apparentlycome mainly from the periosteum and pass through a cartilaginousstage before becoming bone, as do the others that have the same unite promptly w
. A practical treatise on fractures and dislocations. lamella? which lie upon the inner side of the compact new lamelhe extend across the canal, soon occluding it also out into the interval to meet those coming from the otherfragment. Thus is formed the internal or medullary plug. The granulations occupying the annular interval between the corticallayers of the two fragments (when the reduction is complete) apparentlycome mainly from the periosteum and pass through a cartilaginousstage before becoming bone, as do the others that have the same unite promptly with those of the medullary plug and ultimately(sometimes after a long delay) with the cortical layer. It was to thispart of the callus that Dupuytren gave the name of definitive cause of the delay in union with the cortical layer lies in the slow-ness with which the latter forms the granulations necessary to unitewith tl^e others, and doubtless to the occasional long persistence of a 1 Coruil and Coudray, Revue de Chir., 24th year. No. Tibia of rabbit. Seventhday: a, blood; ft, cartilag-inous callus; c, muscles.(Gvrlt.) 60 FRACTURES. necrotic scale of bone on its broken surface, which has to be slowlypenetrated and absorbed by the granulations. The cellular elementsof the cortex, which have to do the work of enlarging the Haversiancanals and forming the granulations, are scanty, and those immediatelyadjoining the broken surface cannot share in the work because theirblood-supply is cut off by the clotting of the blood in the torn capil-laries. The cells situated a little more deeply have to carry on thework and slowly break through the intermediate necrotic scale beforethey can meet and unite with the other granulations that have spreadinto the interval from without and within. This process in the com-pact tissue is the usual rarefying osteitis, characterized by an enlarge-ment of the Haversian canals and a corresponding loss of the bonetissue, a change, in short,
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