5. Summary and Conclusions

Abstract

The results of the operative managment of fractures may be subject to question in the presence of infection. To study fracture healing in the presence of local infection, we performed transverse tibial osteotomies in sheep and stabilised them using different types of plate fixations. Thereafter, human-pathogenic staphylococci were injected locally and produced a chronic bone infection with fistulae, sequestrum formation, osteolysis and callus apposition similar to the condition in human osteitis. After eight weeks 18 out of 19 osteotomies showed patterns of bony union, even partly exhibiting the characteristics of primary bone healing. In vivo measurements of interfragmentary compression showed in most cases a different pattern when compared with the curve earlier described in non-infected osteotomies : a rapid pressure decrease is found between the fourth and the eighth week. In these cases resorption and sequestrum formation were extensive. The measurements of interfragmentary compression showed a good orrelation between stability of the fixation and type of bone healing.