[3-phase bone scintigraphy: perfusion and vitality of the femur head after media femoral neck fracture and osteosynthesis].

UNLABELLED

Perfusion and Vitality of the Femoral Head after Medial Neck Fracture and Osteosynthesis.

AIMS

to analyse with regard to necrosis the perfusion and vitality of the femoral head after medial neck fracture and repair by placement of a dynamic hip screw.

PATIENTS AND METHODS

Twenty-one patients were examined by scintigraphy immediately following operation as well as at 3 and 6 months postoperative for evaluation of dysfunctions of perfusion and mineralization.

RESULTS

Complete perfusion and mineralization defects with a tendency for revascularization at 3 months will be normal at 6 months. Persisting dysfunctions at 3 and 6 months will progress to femoral head necrosis irrespective of the fracture staging.

CONCLUSIONS

Three-phase skeletal scintigraphy is a highly sensitive, non-invasive method for evaluating perfusion and revascularization of the femoral head after femoral neck fracture and repair by means of a dynamic hip screw. When perfusion of the femoral head is observed one week after the trauma, femoral head necrosis will not arise. Immobilization is necessary after partial or complete perfusion and mineralization dysfunctions until the scintigraphic findings return to normal. The present results may serve as a recommendation for loading after fracture repair with a dynamic hip screw.