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THE INFLUENCE OF PERIOSTEUM ON THE SURVIVAL OF BONE GRAFTS
KEENE O. HALDEMAN
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Department of Surgery, Division of Orthopaedic Surgery, of the University of California Medical School
The Journal of Bone & Joint Surgery.  1933; 15:302-319 
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Abstract

In twenty-two rabbits, grafts taken from the tibia or fibula were transplanted to defects which had been produced in each radius. By weekly x-ray observations, and at the end of the experiment by microscopic sections, it was possible to compare different types of grafts in the same animal, namely, fibula, periosteum alone, osteoperiosteal grafts, and cortical grafts with or without periosteum. [SEE THE FIGURE FIG. 12 AND FIG. 13 IN SOURCE PDF.]

It was found that a graft composed of the entire fibula survived longer and favored an earlier closure of the defect than did a graft of fibula without periosteum, or split fibula. A periosteal graft, free from bone, produced an early closure of the defect in every case. The osteoperiosteal graft also resulted in an early closure of the defect, apparently through the activity of the periosteum rather than the fine pieces of cortex which were included in the graft. A comparison of cortical grafts with and without periosteum showed clearly that the presence of periosteum on a graft favored the early closure of the defect and the survival of the graft.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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