[Intravenous peripheral digital subtraction angiography after stabilization of medial femoral neck fractures. Results and value].

In patients with medial femoral neck fractures the condition of the blood vessels is the decisive factor as to whether or not femoral capital necrosis will develop. Therefore, conventional angiography has been used both preoperatively for the diagnostic work-up and for selecting the best mode of management and postoperatively for prognostic purposes. Its routine use has, however, been limited by the long examination time, the complexity of the technique and the potential complications. Peripheral intravenous digital subtraction angiography (DSA) for imaging peripheral vessels is a far less demanding procedure. Its usefulness was studied postoperatively in 7 patients. The vascular information obtained was inferior to that of conventional angiography because of the inherently poorer vessel imaging qualities. Moreover, since its applicability is limited to patients with a completely intact cardiovascular system and normal cardiac output, it is not suitable for most geriatric patients. It is, therefore, concluded that peripheral intravenous DSA cannot (yet) be recommended as a routine procedure. It remains to be seen whether technical improvements in system features will improve the diagnostic performance.