The sequential evaluation of bone scintigraphy: an analysis of revascularised bone grafts.

Technetium-99m Methylene Diphosphonate (Tc-99m MDP) has often been used to assess revascularisation of bone, because positive uptake of Tc-99m MDP reflects patent anastomoses and viability of the grafted bone. However, the sequential evaluation of bone scintigraphy has seldom been reported, especially in clinical cases. We carried out sequential evaluation in 17 patients with revascularised bone grafts. In this series, intense or maximal uptake in the grafted bone was observed in the early days after surgery (1-2 weeks postoperatively), with considerable reduction after 4 weeks. Furthermore, it was found that there was no uptake of Tc-99m MDP when the anastomosed vessels were occluded, even after 6 weeks, and these three cases all developed fracture or sequestrum. We therefore believe that bone scintigraphy is reliable in the postoperative monitoring of revascularised bone for at least 4 or 6 weeks postoperatively.