A system of surgery . aemorrhage and late accidents to vesselsare almost always of septic origin. Theory of the formation of callus. —The majority believe that the formationof bony callus is a reparative, not aninflammatory process, and that it occursonly in the presence of medullary cells,which alone can become experiments have shownthat the cells of the deeper layer of theperiosteum and, in a much feebler degree,those of the medulla, possess the power offorming bone—apart from bone itself; theyapparently do so in fractures, producingthe external and internal callu
A system of surgery . aemorrhage and late accidents to vesselsare almost always of septic origin. Theory of the formation of callus. —The majority believe that the formationof bony callus is a reparative, not aninflammatory process, and that it occursonly in the presence of medullary cells,which alone can become experiments have shownthat the cells of the deeper layer of theperiosteum and, in a much feebler degree,those of the medulla, possess the power offorming bone—apart from bone itself; theyapparently do so in fractures, producingthe external and internal callus, ofwhich the former is by far the moreexuberant, for any effect which the boneand the cells in the Haversian canals may have should tell equallyon both sides; lastly, Oilier carefully removed a zone of periosteum,and broke the bone—no callus formed till the edge of the periosteumwas reached. This has not always been the result, but the evidenceis sufficient to show the great importance of the periosteum in the. Fig. 224.—A compound commi-nuted Fracture of the Tibia andprobably a simple Fracture ofthe Fibula at the Junction ofthe lower and middle fibula is nnited and pre-sents a long uniform curve out-wards, consequent upon ashortening of the tibia due pro-bably to the removal of ends of the tibial frag-ments are swollen by callus inwhich a single splinter iscaught on the outer side. Mostof the tibia and even of thefibula shows a thin layer of newbone. UNION OF FRACTURE. 763 formation of callus; and though it is impossible to demonstrate themultiplication of its cells, or to trace their progeny, yet the viewabove stated receives support from all observations on repair oftissues since Senftlebens experiments on the corneal cells, for alltend to show that the cell-elements of a tissue effect its final andperfect repair. Cohnheim, Maas, and others, on the other hand,regard the process of bone-repair as inflammatory, and the cells incallus as leucocytes
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