. On modern methods of treating fractures . arative materialbetween the bone ends. The callus mass growing from theupper fragment is very sharply defined, and gives the impres-sion of merely forming a cap for the bone end, rather than abridge that is going to stretch across the gap. In Fig. 77 h is seen No. 79, thirty-five days after operation,and here too there is a perfectly clear interval between the cutends of the tibia, with no suggestion of new bone or callus. Inthis case the fibula has fractured, and the exuberant callusformed round the broken ends of the fibula would have beenmore than
. On modern methods of treating fractures . arative materialbetween the bone ends. The callus mass growing from theupper fragment is very sharply defined, and gives the impres-sion of merely forming a cap for the bone end, rather than abridge that is going to stretch across the gap. In Fig. 77 h is seen No. 79, thirty-five days after operation,and here too there is a perfectly clear interval between the cutends of the tibia, with no suggestion of new bone or callus. Inthis case the fibula has fractured, and the exuberant callusformed round the broken ends of the fibula would have beenmore than enough to fill the gap in the tibia. Thus there is astriking example of the absence of callus when bone ends arenot in contact, and the exuberance of callus formed by brokenbone ends which are allowed some movement against each other. In the three cases Nos. 79, 80, and 83 there was no trace ofcallus being laid down by the periosteum, and much less pouringout of callus from the cut bone ends than I expected. In the OPERATIVE TREATMENT 133. Am I -: Fig. 11.—Cats TiBiAs AFTER Subperiosteal Removal of a Piece _ofTHE Shaft in its Whole Thickness. (a). No. 80, after 1-t days. Internal callus best developed in upper in gap. Internal callus. (6). No. 79, after 35 days. Fibula has broken. In the tibial gap there is no newbone, but round the fibular ends there is a big mass of new bone. T, Tibial , Fibula. E. C, External callus. B. Bridge of soft tissues only in the gap betweenbone ends. (c). No. 85, after 42 days. The ends of the bone have been covered in by rubbertissue ; but in spite of this the gap is filled by callus, both cartilage and bone, derivedfrom the periosteum. P, Periosteum. R, Rubber tissue. , New bone in thecartilaginous callus mass. 134 MODERN METHODS OF TREATING FRACTURES two cases Nos. 84 and 85, I wished to eliminate this last factor;for this purpose a small fragment of rubber tissue from a glovewas tied over the cut ends of the bon
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