[Combined osteosynthesis in experiment and clinic (author's transl)]

Animal experimentations of the pathophysiology of bone union after combined osteosyntheses (plate + methylmethacrylate) showed that acrylic cement destroys the intramedullary blood supply. Revascularization of the cortical bone will occur from the periosteum towards the endosteum. With the stability obtained, the osteotomy heals with formation of callus which overbridges the necrotic bone. Increased soft tissue damage delays callus formation and bone revascularization. In a 9 years period, 327 patients were treated with combined osteosynthesis. 231 of them had an unstable pertrochanteric fracture and 96 were treated because of a pathological fracture. There were 9 soft tissue infections, we observed no osteomyelitis. A follow-up of the patients with pertrochanteric fractures showed 81% good and very good results. If stability was obtained, the fractures used to heal.