. General surgical pathology and therapeutics, in fifty lectures : a textbook for students and physicians. PERIOSTEUM, BONE, ETC. fractures: when the broken ends or nearly loose fragments of bonebecome necrosed, the formation of new bone in the vicinitj may notonly induce future firmness in the bone, but the sequestrum may beentirely enclosed by the new bone, and it may be necessary to removeit by operation. But this formation of new bone is most importantin total necrosis of entire diaphyses; it is intended to replace thebone which dies. This very important process, which is so wonder-fully a
. General surgical pathology and therapeutics, in fifty lectures : a textbook for students and physicians. PERIOSTEUM, BONE, ETC. fractures: when the broken ends or nearly loose fragments of bonebecome necrosed, the formation of new bone in the vicinitj may notonly induce future firmness in the bone, but the sequestrum may beentirely enclosed by the new bone, and it may be necessary to removeit by operation. But this formation of new bone is most importantin total necrosis of entire diaphyses; it is intended to replace thebone which dies. This very important process, which is so wonder-fully accomplished by Nature, we must now study more us suppose an acute total periostitis and osteomyelitis with ne-crosis of the diaphysis of the tibia. The entire periosteum and me-dulla have suppurated ; within the bone the pus falls to detritus, oractually putrefies ; the pus from the periosteum has perforated theskin at various points, the circulation in the diaphysis has ceased; theentire diaphysis is a sequestrum. A longitudinal section gives thefollowing appearance (Fig. 79) : Fig. Diagram of total necrosis of the diaphysis of a hollow bone. a, the sequestered bone; b b, its upper and lower extremities; c e,pus surrounding the sequestrum; d d, where it has perforated exter-nally. The darkest layer, e e, is the wall of a large abscess-cavity,which consists of tissue (connective or tendinous tissue, or even ofmuscle), infiltrated with plastic matter, and on its inner surface, whichlies next the sequestrum, like any abscess-cavity, it has a granulation-layer, which constantly produces new pus. I will mention at oncethat this view, as in acute periostitis, differs from that of other sur-geons and anatomists, because they suppose the tendinous portionof the periosteum is lifted, like a vesicle, from the bone by the pus;this is incorrect, because the tendinous portion of the periosteum isnot sufficiently elastic to be quickly elevated like an epidermis vesicle,an
Size: 2581px × 968px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1870, booksubjecttherapeutics, bookyea
