The Osseous System 345 



Fibroma. Fibrous tumors of bone are of such rarity and in 

 clinical features resemble chondroma so closely that they need not 

 be considered here. 



Sarcoma. This, the malignant type of growth occurring in bone, 

 will be found fully described in the chapter on Neoplasms, and 

 needs but a passing reference here. 



Symptoms and Diagnosis. It is distinguished from the inno- 

 cent growths by its steady, progressive and rapid development, 

 and by other characteristics described elsewhere. 



Treatment. Ablation of this form of growth is difficult to 

 attain. When practicable it must always be most thorough. 



Carcinoma occurs only as a secondary manifestation, Puetz 

 has seen it in the epiphyses of the elbow joint. 



OSTEOPLASTY 



This term is applied to certain operations or processes by which 

 defects in the continuity of bones are remedied.. The value of its 

 application to cases of severe comminuted fracture with absorption 

 or necrosis of the detached portions, in the treatment of osteomye- 

 litis, and the correction of pseudarthrodic formation following frac- 

 ture, has long been recognized. We find the earliest known in- 

 stance of its practice recorded by a Mongolian surgeon named Baber 

 who lived between the years 1483 and 1530 and wrote his life-doings 

 in the Turkish dialect. The reference concerns a man who broke 

 his leg in such a manner that part of the bone of the size of the 

 hand was completely shattered. He cut open the integuments, ex- 

 tracted the detached portions and inserted in their place a pulver- 

 ized preparation, which was said to have grown in place of the bone, 

 and resulted in its complete recovery. 



A great many experiments in this direction have been carried 

 out on dogs by Oilier, Schede, Schmitt (37 experiments), Adam- 

 kiewicz, Rydygier and others in Europe, and by Senn and Mackie 

 and others in this country. 



It was observed that cavities or serious breaks in the continuity 

 of bones were always followed by protracted regenerative processes. 

 Hence efforts were directed towards the finding of some substitute 

 which, when implanted in the defect, would take the place of the 

 missing bone and become intimately merged with the main body. 

 Many substances were employed to act as substitutes, among them 



