S.M. Perren – författare

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.

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.

The papers presented at the Fourth ''Meeting of the European Society of Biomechanics, held in collaboration with the European Society for Biomaterials in late September 1984 in Davos, Switzerland, are published herewith. The main idea of the meeting was to gather together the many disciplines of researchers and clinicians active and interested in promoting biomechanical knowledge in one interdisciplinary society: the European Society of Biomechanics. We feel that the dialog across the disciplines is one of the important goals of the society, a goal which can be furthered by meetings like the one in Davos. A surgeon, whether a general, trauma or orthopaedic surgeon, is normally brought up without relevant exposure to spe­ cific technical problems. It therefore is not surprising that he speaks a different language with respect to mechanical problems than an engineer. Although a surgeon often has a feeling for what the solution to a particular problem might be, a fruitful inter­ disciplinary collaboration is made difficult by this scientific language barrier. On the other hand, a physicist, chemist, engi­ neer and metallurgist, to name a few, would do well with a realistic perception of the possibilities and limitations of surgery and of the relevance of a solution found to the initial question. Similar problems exist in other areas, e. g. in the field of sports biomechanics in the dialogue betweeen coach and researcher. Interdisciplinary misunderstandings have led to quite some unaeces£ary frustration in the past.