The healing of fractures varies in pattern within wide limits, depending on several factors. Taking the degree of stabilisation as a parameter, it is usually found that the more rigid the fixation the less the periosteal reaction. This can be observed clinically in the healing of fractures fixed by stable osteosynthesis, in so far as radiologically visible callus seldom appears. If callus does appear it is often an indication ofinadequate stability (Weiser and Allgower 1962). With adequate stability, direct bone bridging of the fracture gap-the " soudure autog#{233}ne"-takes place (Danis 1949). Willenegger, Schenk, Straumann, MUller, Allgower and KrUger (1962) verified this hypothesis experimentally in sheep and dogs, which Danis had based on clinical experience. Schenk and Willenegger (1963, 1964) studied the healing of fractures histologically after fixation with compression and observed what they called " intracanalicular osteogenesis "-that is, direct formation of secondary osteones across the fracture gap. After the first phase of bone healing, with exudation, a vascular reaction follows. New vessels branch out from undamaged blood vessels adjacent to the fracture site and invade * The terramycin was kindly supplied by Pfizer Ltd.
Two cases of genu recurvatum deformity and leg length discrepancy after partial growth arrest of the proximal tibial physis are described. The patients are both boys thirteen and fifteen years old respectively. The etiology of the deformity is considered to be local pressure on the tibial tuberosity, in the first case after treatment with plaster cast after correction of an angular deformity in a tibial fracture and in the second case after prolonged treatment with patellar tendon bearing brace. The boys were treated with physeal distraction which corrected both the leg length discrepancy and the angular deformity. The technique is recommended because the correction is done at the site of the deformity and knee motion is possible during the entire treatment period.
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