Femoral head viability following hip fracture. Prognostic role of radionuclide bone imaging.
A retrospective study was made of all radionuclide (RN) bone images performed at our institution over a two-year period to evaluate femoral head viability after nonpathologic fracture of the femoral neck. Twelve patients had avascular femoral heads during the perioperative period, of which nine had adequate follow-up. Seven of these nine patients had follow-up bone images. Revascularization occurred in four patients, while three had persistent absence of femoral head uptake. With clinical follow-up ranging from four to 29 months (median: 14 months), only two of these nine patients developed clinical or radiographic evidence of osteonecrosis. RN bone imaging performed in the perioperative period does not reliably predict the development of post-traumatic osteonecrosis of the femoral head and, at present, should not be used to determine prospectively method of treatment of femoral neck fracture.
D000328:Adult; D016025:Bone Transplantation; D004164:Diphosphonates; D005265:Femoral Neck Fractures / Q000601:surgery*; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging* / Q000209:etiology; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006622:Hip Prosthesis; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011877:Radionuclide Imaging; D013667:Technetium; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*
D004164:Diphosphonates; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013667:Technetium; D013669:Technetium Tc 99m Medronate