This paper is only available as a PDF. To read, Please Download here.
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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Subcapital fractures of the femur. A prospective review.J. Bane Joint Surg. 1976; 58B: 2
- Low angle fixation in fractures of the femoral neck.J. Bone Joint Surg. 1961; 43B: 647
- Early detection by 99m TCNS-pyrophosphate scintigraphy of femoral head necrosis following medial femoral neck fractures.Acta Orthop. Scand. 1980; 51: 119
- Preoperative 99m TC-MDP scintimetry of femoral neck fractures.Acta Orthop. Scand. 1984; 55: 430
- Roentengenologic manifestations of osteonecrosis.Am. J. Roentgenol. 1969; 106: 509
- Necrosis of the femoral head following femoral neck fractures.Injury. 1986; 17: 345
- Femoral neck fractures: sliding screw-plate versus sliding nail-plate. A randomised trial.Injury. 1985; 16: 449
- Early scintigraphic diagnosis of femoral head necrosis following femoral neck fractures.Chin. Med. J. 1983; 96: 897
- Technetium-99m-methylenediphosphonate scintimetry after femoral neck fractures. A three-year follow-up study.Clin. Orthop. 1984; 182: 177
Article info
Publication history
Accepted:
March 24,
1986
Identification
Copyright
© 1987 Published by Elsevier Inc.
