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The Bone & Joint Journal

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The Journal of Bone & Joint Surgery British Volume
Vol. 85-B, Issue 2 | Pages 310 - 310
1 Mar 2003
Wallace A


The Journal of Bone & Joint Surgery British Volume
Vol. 73-B, Issue 5 | Pages 819 - 825
1 Sep 1991
Wallace A Draper E Strachan R McCarthy I Hughes S

We examined the effect of periosteal devascularisation upon the early healing of osteotomies of sheep tibiae held in an instrumented external fixation system with an axial stiffness of 240 N/mm. At 14 days, cortical blood flow measured by the microsphere technique was 19.3 ml/min/100g in the well-vascularised osteotomies, but only 1.7 ml/min/100g in the devascularised osteotomies, despite an increase in medullary flow (p less than 0.0005). Delay in healing of the devascularised osteotomies was suggested by an in vivo monitoring system and confirmed by post-mortem mechanical testing. We suggest that the osteogenic stimulus of dynamic external fixation is dependent on the early restoration of cortical blood flow in devascularised fractures.