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,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,2011/9/15,#,The role of preoperative bone scan for determining the treatmentmethod for femoral neck fracture,International Orthopaedics(SICOT)(2007)31:6164,Abstract,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,.,Introduction,Femoral neck fracture is still known as“unsolved fracture”because it is frequently complicated by,avascular necrosis or non-union,.,Blood supply,to the femoral head can be disturbed by a femoral neck fracture due to,anatomical characteristics,and this is considered to be a major cause of non-union or,avascular necrosis of the femoral head,.,In this study,we,evaluated,the role of preoperative bone scan for determining the operative method for femoral neck fracture.,Materials and methods,Between,January 1998 and December 2003,a total of 83 patients with femoral neck fracture had a preoperative bone scintigram.,They were,21 men and 62 women,with an average age of 67.0 years(range,1893 years).,Preoperative bone scanning was performed using,99mTc-MDP.,a Radioisotope uptake is reduced in both anterior and posterior views(category R:,overall reduction,in activity).,b Radioisotope uptake is reduced in the anterior or posterior view(category P:,partial reduction,in activity).,c Radioisotope uptake is normal or increased(category N:,normal orincreased activity),Results,In general,preoperative,radioisotope uptake,in the femoral head on the fractured side,corresponded,with the degree of,fracture displacement,.,This is,the only case,in this series in which the operative method was changed because of bone scan findings.,In,three cases,with radioisotope uptake of N,replacement arthroplasty,was performed because of their age(74,80 and 87).,Discussion,Many studies have reported that 99mTc-MDP bone scans are,useful,for assessing the,prognosis,of femoral neck fractures.,Catto suggested that a,displaced,fracture has a,poorer prognosis than a non-displaced,fracture because blood supply to the femoral head is decreased 2.,Degree of,fracture displacement,and,patient age,are,important factors when deciding on the method of operation 13.,Summary,We are forced to conclude that preoperative bone scan has,no significant role,in deciding on operative method in cases of femoral neck fracture.,Degree of,fracture displacement,and patient,age,are,important factors when deciding on the method of,operation.,One study found that blood flow improves after,anatomical reduction of a,displaced,femoral neck,fracture,and recommended,anatomical reduction,to reduce complications,.,Thank you!,
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