The danger of infection remains the most serious drawback to
internal fixation. Prevention, using all available prophylactic
measures should be the central feature in every surgical
department. Though the infection rate may remain below the
acceptable level of 2 %, the infected patient derives little
comfort from the large number of excellent results in other people.
We must discover the best way to offer these patients a favourable
prognosis. This should not be based on intuition but on clear
proven guiding principles. Planning the treatment for a patient
whose internal fixation has become septic must decide between steps
which may have advantages or disadvan tages. The disadvantage of
the presence of a foreign body must be weighed against the
advantage of rigidity. The authors have taken up this challenge by
planned animal experiments to study the healing of internally fixed
fractures which have been infected with staphylococci. They have
shown that under stable conditions, even massive infection did not
destroy the healing process in cortical bone. Even under these
circumstances fracture union, in the form of primary bone healing,
can occur even if with less regularity than in unin fected internal
fixation.
General
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