Bone transplantation as a treatment of Pott's disease, club feet and ununited fractures / by Fred H. Albee.

  • Albee, Fred H. (Fred Houdlett), 1876-1945.
Date:
[1912]
Catalogue details

Licence: In copyright

Credit: Bone transplantation as a treatment of Pott's disease, club feet and ununited fractures / by Fred H. Albee. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Vol. XXVII Number 11 BONE TRANSPLANTATION. 7 fixation of those vertebrae involved, even before union takes place. The immediate fixation thus obtained must be far more perfect than that secured by any external orthopedic means, as plaster jackets, etc. This has been especially confirmed by the im- mediate disappearance of pain in adults and pain and night cries in children, (i.e. within a few days.) The environment of the spinal insert thus placed is most favorable, it is not only wedged into well nourished healthy spinous processes, which are less than three-quarter inch apart, but is also surrounded throughout its whole extent by ligamentous tissue, which is normally attached to bone. The conditions are very favorable to a rapid establish- ment of an Haversian blood supply from the spinous processes to graft. The writer believes that the fact that his spinal grafts have showed no evidence of disintegration or absorption, is explained in this way. In four cases, where the kyphosis was very marked and angular, green stick fractures of both halves of the prominent spinous process were produced (by help of oste- otomy) and about one-third to two-thirds of their tips turned in laterally and sutured in contact with posterior surface of trans- plant. Thus producing additional bone contacts for graft and reducing the kyphosis by so much. On August 5th, 1912 at Bellevue Hospital a spinal graft which had been inserted, seven (7) weeks before, was cut down upon and carefully examined. The case was that of a child who had a large kyphosis and the graft had been bent into place under considerable tension. Although the spinal deformity had become straightened a good deal at the operation and from the constant tension of the bent bone plate afterwards (as of a bow) the upper end of the graft had become disengaged from the tips of the spinous processes and had sprung posteriorly into the soft tissues. The graft was firmly united to all the spinous processes with which it was in contact. There had been a large amount of new bone formation about the graft and tips of the spinous processes. The graft had become increased in its diameter between the spinous processes with which it had become united. The projecting ends had increased but slightly. Careful inspection failed to find any evidence of bone degeneration or absorption. About one-half inch of its upper end was removed with bone forceps. The cut end of the transplant bled uniformly through-