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An intravital staining method was used to predict the viability of the femoral head at operation in 36 patients with fractures of the neck of the femur. Life was predicted in 18 heads, death in 16 and in 2 there was some doubt.
In the group which was predicted to be live, 15 fractures united uneventfully, 1 developed late collapse and 2 became infected and died. Of the heads predicted to be dead, 3 united without evidence of necrosis, four had radiological changes suggesting that necrosis had been followed by revascularization and 10 required further operations. Histological evidence was later obtained in 19 cases. Of 6 heads predicted to be live, 4 had united without evidence of necrosis, 1 showed necrosis and collapse and 1 was infected and dead. Of the heads predicted to be dead, 8 were dead, 4 showed revascularization taking place and 1 showed no evidence of bone necrosis. Intravital staining is a relatively easy technique but has limitations as a means of predicting the clinical outcome.
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