[3-phase bone scintigraphy: perfusion and vitality of the femur head after media femoral neck fracture and osteosynthesis].
Perfusion and Vitality of the Femoral Head after Medial Neck Fracture and Osteosynthesis.


OBJECTIVE
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.


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.
Einert
A
A
Abt. Nuklearmedizin, Radiologische Universitätsklinik Freiburg.
Bonnaire
F
F
Simon
G H
GH
Kuner
E
E
Moser
E
E
D000328:Adult; D000368:Aged; D015519:Bone Density / Q000502:physiology; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005270:Femur Head / Q000098:blood supply* / Q000000981:diagnostic imaging; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012039:Regional Blood Flow / Q000502:physiology