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Abstract
The relationship between the radiological and histological findings was studied in
a series of rabbit osteotomies and fractures stabilized with plates with and without
longitudinal compression.
When compression was employed, the gap varied between 10 and 200 μm and no radiologically
visible callus was seen. After 4 weeks the smallest gaps of 10–30 μm were filled histologically
with structureless material, while the larger gaps contained ‘cortical’ bone derived
from periosteal and endosteal proliferation. The degree of union could not be assessed
from X-ray examination, as there was no correlation between the histological and radiological
appearances.
When no compression was employed, the gap varied between 200–1200 μm; radiologically
visible periosteal callus and filling of the gap indicated that consolidation had
appeared in four weeks. Gaps of 200–500 μm were filled with bone derived from the
periosteum and endosteum of lamellar structure which had invaded the original cortical
bone (‘plugging’). When the gaps were more than 500 μm, islands of cartilage and connective
tissue were found. In all cases studied, many ‘anchoring osteons’ passed from the
endosteal and periosteal callus into the original cortical bone.
It is concluded that a ‘compression internal fixation’ of cortical bone will not necessarily
secure union, as histologically confirmed, even when the formation of radiologically
visible callus is suppressed. The lack of periosteal callus appears to be the result
of a small gap and rigid fixation, rather than related to strains induced in the bone.
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© 1979 Published by Elsevier Inc.