A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . g bone, if ex-amined sufficiently long after the time offracture, has the microscropic structure oftrue bone. Bones are repaired by the same generalprocess as are other tissues. The cells ofthe periosteum and marrow and those lin-ing the Haversian canals and the lacunasof the bone multiply. By this prolif-eration is formed a mass of granulationtissue, which fills the spaces between thepieces of bone and sometimes infiltratesthe
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . g bone, if ex-amined sufficiently long after the time offracture, has the microscropic structure oftrue bone. Bones are repaired by the same generalprocess as are other tissues. The cells ofthe periosteum and marrow and those lin-ing the Haversian canals and the lacunasof the bone multiply. By this prolif-eration is formed a mass of granulationtissue, which fills the spaces between thepieces of bone and sometimes infiltratesthe parts around the bone. This newgerminal material gradually becomes ossi-fied, by the deposition of earthy salts at numerous points and the subse-quent coalescence of these ossific centers. The time after fracture atwhich bony particles are first formed in the bond of union is probably twoor three weeks, and ossification is accomplished in from four to eightweeks more. The transition from granulation tissue to bone is usuallythrough the connective-tissue stage ; though occasionally the granula-tion material, at least in some parts, becomes cartilage before it is. Fracture three weeks old; periostealand medullary callus partly ossified,partly cartilaginous ; P, periosteum ; K,tone; 31, medulla. (Tillmanns.) 360 FRACTURES. transformed into bone. Some of the new bone, which is at first spongyin structure, becomes compact; some of it becomes more rarefied, andsome is entirely absorbed ; until, finally, if the fragments have beenkept in correct apposition, the bone is so well restored to its normalcondition that, even when the dried bone is sawn open, no line of frac-ture can with certainty be distinguished. After the shaft of bone is fractuied the periosteum, torn and strippedup from the bone though it may be, often forms a sort of raggedsheath around the seat of fracture. Within the limits of this imper-fect periosteal sheath new tissue to unite the bone is principally de-posited.
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