Dong Q R, Wang J X, Dong T H
Service d'Orthopédie, Hôpital n. 1, Collège de Médecine de Suzhou, R.P. Chine.
J Radiol. 1994 Aug-Sep;75(8-9):423-5.
In order to obtain an early prediction for segmental collapse of the femoral head after femoral neck fracture, we have studied in 53 cases of the femoral neck fracture using 99mTC-MDP scintimetry. According to the radionuclide uptake ratio of the femoral heads, we can estimate the gravity of the avascular necrosis of the femoral head after fracture and recognize the repair process in the necrotic head. Fifty-three cases of fresh fracture were examined by sequential scintigraphy before operation and during follow up examinations after operation. The radionuclide uptake were all increased in 3 to 4 months after operation as comparing with that done before operation. The uptake ratios in 37 cases decreased gradually and approached 1 in 12 months after operation. All of them have an excellent result during follow up examination 36 months after surgery. The uptake ratios in 19 cases were also increased after operation, but still maintained at a high level in 6 to 12 months. They all showed radiographical signs of segmental collapse 18 to 24 months after operation. These results showed that uptake ratio of the radionuclide bone imaging is able to predict the occurrence of segmental collapse of the femoral head after femoral neck fracture. The time of the diagnosis by scintigraphy for segmental collapse of the femoral head is earlier than that by radiography.
为了对股骨颈骨折后股骨头的节段性塌陷获得早期预测，我们使用99mTC-MDP骨闪烁显像术对53例股骨颈骨折患者进行了研究。根据股骨头的放射性核素摄取率，我们可以估计骨折后股骨头缺血性坏死的严重程度，并识别坏死股骨头的修复过程。对53例新鲜骨折患者在术前及术后随访期间进行了连续闪烁显像检查。与术前相比，术后3至4个月放射性核素摄取均增加。37例患者的摄取率逐渐下降，术后12个月接近1。在术后36个月的随访检查中，他们的结果均良好。19例患者术后摄取率也升高，但在6至12个月仍维持在较高水平。他们在术后18至24个月均出现了节段性塌陷的影像学征象。这些结果表明，放射性核素骨显像的摄取率能够预测股骨颈骨折后股骨头节段性塌陷的发生。骨闪烁显像对股骨头节段性塌陷的诊断时间早于X线摄影。
