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Research Article| Volume 18, ISSUE 1, P33-35, January 1987

The predictive value of bone scintigraphy after internal fixation of femoral neck fractures

  • Stig Sonne-Holm
    Correspondence
    Requests for reprints should be addressed to: Stig Sonne-Holm, L. E. Bruuns Vej 27, DK-2920 Charlottenlund, Denmark.
    Affiliations
    Departments of Orthopaedic Surgery T-2 and T-3 and Department of Clinical Physiology, Gentofte Hospital, University of Copenhagen, Denmark
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  • Peter Nordkild
    Affiliations
    Departments of Orthopaedic Surgery T-2 and T-3 and Department of Clinical Physiology, Gentofte Hospital, University of Copenhagen, Denmark
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  • Martin Dyrbye
    Affiliations
    Departments of Orthopaedic Surgery T-2 and T-3 and Department of Clinical Physiology, Gentofte Hospital, University of Copenhagen, Denmark
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  • Jørgen Steen Jensen
    Affiliations
    Departments of Orthopaedic Surgery T-2 and T-3 and Department of Clinical Physiology, Gentofte Hospital, University of Copenhagen, Denmark
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DOI:https://doi.org/10.1016/0020-1383(87)90382-2
The predictive value of bone scintigraphy after internal fixation of femoral neck fractures
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      Abstract

      Persisting pain of the hip following internal fixation of fracture of the neck of the femur is often caused by capital necrosis or non-union. In a randomized trial 35 patients had 99Tcm-MDP bone scintigraphy performed 6 weeks, 3, 6 and 12 months after internal fixation of their subcapital fractures with a sliding screw-plate or a sliding nail-plate. The purpose was to find out whether bone scintigraphy could predict capital necrosis or non-union before it shows up on plain radiographs, which happens later. The patients were followed up for an average of 44 months (range 12–64). Radiologically, capital necrosis occurred in five patients and non-union in six. Bone scintigraphy showed decreasing activity in the 1st year after operation in uncomplicated cases (P < 0.03). However, it was impossible to distinguish patients with capital necrosis or non-union from those with uneventful healing. There were no significant differences in the scintigraphic appearance between groups at most risk, e.g. Garden stage 3 and 4 fractures versus Garden stage 1 and 2, and fixation by sliding nail versus fixation by sliding screw-plate. In conclusion, bone scintigrams during the first 6 months after operation do not reliably predict failure of internal fixation of fractures of the neck of the femur.
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      Article info

      Publication history

      Accepted: March 24, 1986

      Identification

      DOI: https://doi.org/10.1016/0020-1383(87)90382-2

      Copyright

      © 1987 Published by Elsevier Inc.

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