Early Detection by<sup>99m</sup>Tc-Sn-Pyrophosphate Scintigraphy of Femoral head Necrosis Following Medial Femoral Neck Fractures

Greiff, Jørgen; Lanng, S; Høilund-Carlsen, Poul Fl.; Karle, A; Uhrenholdt, A

doi:10.3109/17453678008990776

Cited by 32 publications

(8 citation statements)

References 18 publications

(3 reference statements)

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“…This discrepancy should probably mainly be attributed to the surrounding acetabular activity. The findings of Greiff et al (1980) suggest that visual assessment on an average of 6 and 11 weeks after fracture has prognostic value regarding subsequent development of late segmental collapse.…”

Section: Scintimetry After Hip Fracture 221mentioning

confidence: 95%

“…In the scintimetric studies of cervical hip fractures, interest has been mainly focused on osteonecrosis as a cause of late segmental collapse (D'Ambrosia et al 1976, Greiff et al 1980, Lucie et al 1981. However, nonunion often produces severe clinical symptoms, whereas this is not necessarily so in late segmental collapse (Kofoed & Alberts 1980, Svenningsen et al 1984.…”

Section: Introductionmentioning

confidence: 99%

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Sequential scintimetry after femoral neck fracture: Methodologic aspects and prediction of healing complications

Alberts

Dahlborn

Ringertz

1987

Acta Orthopaedica Scandinavica

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Forty-five patients with recent cervical hip fractures were included in a prospective, clinical, radiographic and sequential scintimetric study. Striking changes in radionuclide uptake over the entire hip region on the fracture side were found during the first 5 postoperative months. Fractures that healed without complications showed the highest relative femoral head uptake at 1 week and a peak value at 6 weeks, followed by a gradual decline at the subsequent examinations. Fractures with complications (redisplacement, nonunion, or late segmental collapse) showed a lower initial uptake and a more gradual increase and only a slight tendency towards increased uptake after 3 months, The accuracy in predicting nonunion with scintimetric examination alone is high both at 1 and at 6 weeks, and the accuracy is almost equally high with combined scintimetric, radiographic, and clinical assessment 3-5 months postoperatively.

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Section: Scintimetry After Hip Fracture 221mentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Sequential scintimetry after femoral neck fracture: Methodologic aspects and prediction of healing complications

Alberts

Dahlborn

Ringertz

1987

Acta Orthopaedica Scandinavica

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“…Thus, if the status of blood flow to the femoral head could be evaluated before surgery, it would be helpful when deciding on the method of operation. Tc-99m methylenediphosphonate ( 99m Tc-MDP) bone scans are used to determine prognosis after internal fixation of femoral neck fractures, because these scans reflect blood flow in bone tissue [1,4,7,11,14].…”

Section: Introductionmentioning

confidence: 99%

The role of preoperative bone scan for determining the treatment method for femoral neck fracture

Kim

Nam

Yoo

et al. 2006

International Orthopaedics (SICO

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To evaluate the role of preoperative bone scintigraphy in determining the operative treatment method for femoral neck fracture, we reviewed the data of 83 patients who underwent preoperative bone scanning after femoral neck fracture. Fractures were classified using the Garden staging system. Radioisotope uptake in femoral heads was evaluated visually. Of 28 patients with Garden stage I or II, radioactivity of the femoral head was normal in 26, partially reduced in one, and generally reduced in one patient. Twenty-seven patients were treated by closed reduction and multiple pinning, and one patient was treated by bipolar hemiarthroplasty. Of 55 patients with Garden stage III or IV, femoral-head radioactivity was normal in three, partially reduced in seven and generally reduced in 45 patients. Fifty-four patients were treated by bipolar hemiarthroplasty or total hip arthroplasty, and one patient was treated by closed reduction and multiple pinning. In only one of the 83 cases was the operative method changed because of bone scan findings. Isotope uptake of the femoral head after femoral neck fracture generally corresponded with the degree of fracture displacement. Preoperative bone scans appear to have no significant role to play in determining the operative treatment method for femoral neck fracture.Résumé Afin d'évaluer le rôle préopératoire de la scintigraphie osseuse dans les fractures du col du fémur, nous avons revu les dossiers de 83 patients qui ont présenté une fracture du col fémoral. La fracture a été classée selon la classification de Garden. Sur les 28 patients Garden I et II, la réponse scintigraphique de la tête fémorale est normale pour 26 patients, avec une hypofixation osseuse pour un patient et une fixation peu importante chez un autre patient. 27 patients ont été traités par réduction orthopé-dique et embrochage à foyer fermé, un patient par hémiarthroplastie. Pour les 55 patients présentant une fracture Garden III ou IV, la scintigraphie de la tête fémorale a été normale chez trois patients avec une hypofixation chez 7 patients, une fixation très réduite chez 45 patients. 54 patients ont été traités par hémi-arthroplastie ou par prothèse totale et un patient traité par réduction orthopédique et embrochage. Chez un seul des 83 patients, la méthode opératoire a été changée après les constatations scanographiques. La fixation isotopique après fracture du col fémoral correspond tout à fait au degré et au déplacement de la fracture. Le scanner préopératoire ne semble pas avoir d'intérêt pour déterminer le traitement optimum chez ces patients.

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“…As these authors dealt mainly with the late repair process after avascularity and collapse of the femoral head, no contradiction exists between their findings and the findings of McGrail et al (1974), Riggins et al (1 974), D'Ambroiia et al (1975a) and Stadalnik et al (1975) who in studies of medial femoral neck fractures using F'* scintigraphs could diagnose the avascularity of the femoral heads by the lack of isotope accumulation in the area. The scintigraphs produced by D' Ambrosia et al (1975b) who used 99mTc-diphosphonate, by Greiff et al (1980) who used 99mTc-Snpyrophosphate and by Meyers et al (1977) who used 99mTc-sulphur-colloid all demonstrated clearly the vascular/avascular status of the femoral head following medial neck fractures.…”

Section: The Distribution Of Qqmtc-snpyrophosphate In a Patient With mentioning

confidence: 99%

Early Detection by^99mTc-Sn-Pyrophosphate Scintigraphy of Femoral head Necrosis Following Medial Femoral Neck Fractures

Cited by 32 publications

References 18 publications

Sequential scintimetry after femoral neck fracture: Methodologic aspects and prediction of healing complications

Sequential scintimetry after femoral neck fracture: Methodologic aspects and prediction of healing complications

The role of preoperative bone scan for determining the treatment method for femoral neck fracture

Determination of the Vitality of the Femoral Head with^99mTc-Sn-Pyrophosphate Scintigraphy

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Early Detection by99mTc-Sn-Pyrophosphate Scintigraphy of Femoral head Necrosis Following Medial Femoral Neck Fractures

Cited by 32 publications

References 18 publications

Sequential scintimetry after femoral neck fracture: Methodologic aspects and prediction of healing complications

Sequential scintimetry after femoral neck fracture: Methodologic aspects and prediction of healing complications

The role of preoperative bone scan for determining the treatment method for femoral neck fracture

Determination of the Vitality of the Femoral Head with99mTc-Sn-Pyrophosphate Scintigraphy

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Early Detection by^99mTc-Sn-Pyrophosphate Scintigraphy of Femoral head Necrosis Following Medial Femoral Neck Fractures

Determination of the Vitality of the Femoral Head with^99mTc-Sn-Pyrophosphate Scintigraphy