Scintigraphical observation to predict fracture healing in intracapsular fracture of the femoral neck.

Predictive clinical value of scintigraphical classification of the femoral head in intracapsular fracture of the femoral neck, as classified by Hirano, et al. in 1987, was investigated by long-term follow-up (mean; 4 years and 7 months). Normal healing was achieved in 21 of 24 patients. In those cases, early 99mTc-MDP scintigraphy revealed an over-all increase of radionuclide uptake (Type A) and band-like decrease along the fracture (Type B1). Late segmental collapse of the femoral head was found in 3 patients who showed either a decrease in the weight-bearing area (Type B2) or over-all decrease of radionuclide uptake (Type C). The results of fracture healing were well correlated to each type of scintigraphical classification. The changes of radionuclide uptake in the fracture site were also followed by serial 99mTc-MDP scintigraphy.