. General surgical pathology and therapeutics, in fifty lectures : a textbook for students and physicians. Fig. 57. Diagram of fracture of a long bone withexternal wound, longitudinal size, ee, bone; ////, soft partsof the limb; aaaa, necrosed ends ofbone. The darkly-shaded part repre-sents the granulations, which line {<X)the wound that opens outwardly, andsecrete pus ; b b, internal callus in thetwo dislocated ends of bone; cc exter-nal Amputation stump ofthe thigh, with necro-sis of the sawed sur-face. 210 OPEN FRACTURES AND SUPPURATION OF BONE. fragments takes p
. General surgical pathology and therapeutics, in fifty lectures : a textbook for students and physicians. Fig. 57. Diagram of fracture of a long bone withexternal wound, longitudinal size, ee, bone; ////, soft partsof the limb; aaaa, necrosed ends ofbone. The darkly-shaded part repre-sents the granulations, which line {<X)the wound that opens outwardly, andsecrete pus ; b b, internal callus in thetwo dislocated ends of bone; cc exter-nal Amputation stump ofthe thigh, with necro-sis of the sawed sur-face. 210 OPEN FRACTURES AND SUPPURATION OF BONE. fragments takes place either by reabsorption or by artificial removaloutwardly; the former is the more frequent in small, the latter inlarge sequestra; but union will not result as long as the sequestrumremains between the granulations of the fragments. Since the open«ing at d may be much contracted by the development of externalcallus, the operative removal of the necrosed ends is often very diffi-cult. We find, by examination with the probe, whether such seques-tra in the deeper parts really existed, and if they are detached. Ifyou suppose the sequestrum, a a (Fig. 56), removed from the wound,there is no obstacle to the filling of the wound with granulations andto their subsequent ossification. Such sequestra in complicated frac-tures are frequently the cause, not only of new exacerbations of theacute suppurative inflammation, but also of subacute and chronic peri-ostitis
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