Avascular necrosis associated with nailing of femoral neck fracture. Two cases examined pre- and postoperatively by tetracycline and radionuclide tracer techniques.
Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. Sr85-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occurred during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures.
D000328:Adult; D000368:Aged; D001858:Bone Nails / Q000009:adverse effects*; D004164:Diphosphonates; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D013326:Strontium Radioisotopes; D013667:Technetium; D013669:Technetium Tc 99m Medronate; D013752:Tetracycline; D013997:Time Factors
D004164:Diphosphonates; D013326:Strontium Radioisotopes; D013667:Technetium; D013752:Tetracycline; D013669:Technetium Tc 99m Medronate