Assessment of healing of long-bone fractures by intraosseous venography.
Intraosseous venography with compression of the soft tissue was performed following fracture of the radius in 13 dogs to assess the repair process. Two angiographic criteria were analyzed: (a) intraosseous venous crossing of the fracture ("medullary crossing") and (b) capillary blush of the proximal osseous fragment ("proximal blush"). The bone strength of the fractured and intact radii was compared. Venograms obtained immediately after fracture showed contrast material reaching but not crossing the fracture line, indicating that the entire intramedullary venous network had been disrupted. When Parafilm was interposed between the bone fragments to prevent healing, proximal blush was seen at 4 weeks and medullary crossing at 6-7 weeks; bone strength was 13-14% of normal. With no barrier, proximal blush appeared at 5 weeks and medullary crossing at 10-11 weeks; bone strength was 30-40% of normal. The authors conclude that medullary crossing can be seen in the presence of decreased bone strength if the healing process is uneven across the fracture line, as occurred with Parafilm. If the animal model reproduces the clinical situation, this finding challenges the predictive value of intraosseous venography.
D000818:Animals; D004285:Dogs; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010690:Phlebography / Q000379:methods*; D014945:Wound Healing