A method for the production of increased compression strength of bone: An experimental study (preliminary report)

Abstract

in 1021, pro~eeding upon the assumptions that in case5 of fragilitas ossiuni (1) union iiearly always occurs and therefore calcium irietabolism i5 not at falilt. and t h a t ( 8 ) succeeding fractures rarely oc'eur a t the site of fornier one5 and therefore bony union has 5trengthcned the bone, carried out in one 5urh patient an operation similar to that of Barth's,l although unaware of Barth's work. The latter in 190s had removed longitudinal sections from the lorig bones in a case of juvenile o\teomalacia, ground these sections into dust. and replaccd the dust in the space from which the bone had been reiiiovcd. In his report of the case he states that no further fractures occurred. Dr. Arcshibald's opcrntiori differed only in that the removed bone section waS roiigeiired into 5mall fragments instead of being ground into dust. Thcsc sections were plaeed in the niedullary canal and the periostcinn suturrd 01 cr t h e m Ry this procedure he hoped that thc bones would be strengthened, : i n d the tendency toward repeated fractures lessened.It is true that the fact that subsequent fractures do not oc'cur a t the sitc of pre\w)iis ones is reported in the literature in several instances where cascs wcre observed ox er :t long period. but tlic reporters making these statcnicnts (lo not say how they arrived a t this conelusion. As a matter of fact, thc tliseasc being one of c~hildhood, it i5 (iiflkult to state, on account of the growth in length of the boncs, exactly where fresh fractures occur in respect of t h r site ol' a previou5 fracture. At two sukequent operations i n Dr. Archibald's case, performed in 192s on account of the occurrence of fresh fractures, small iiietal markers were inserted at the extremities of the opening left by t h r removal of the bony segment. I n 1929 this patient siiffered recurring fractures of both bones hctweeri the markers. A further attempt t o increaw hone strength was then iiiadc by doing the same operation on the opposite sidc t o that of the first operation, in this ca>e on the tibia, with the result that it gradually became clear that some better means of increasing bone strength had t o be found if these cases of fragilitas ossiuni were to be helped, and tlir 1% ritcr, at the sugge5tion of lh. Archibald. began in 1920 an experimental in\ estigation d o n g these lines.