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KMID : 0386720030150030231
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Journal of the Korean Hip Society
2003 Volume.15 No. 3 p.231 ~ p.237
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Quantitative Analysis of Postoperative "-Tc-MDP Bone Scan aftern Femoral Neck Fracture for Prognostic Precision
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Suh Kuen-Tak
Ku Ja-Gyung
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Abstract
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Purpose: To report the effectiveness of the quantitative analysis of technetium-99m methylene diphosphonate (´Fc-MDP) bone scans in the early prediction of postoperative complications, such as avascular necrosis of the femoral head (AVN) and nonunion and loss of fixation in a femoral neck fracture.
Materials and Methods: Two week postoperative "~Tc-MDP bone scans were quantitatively analyzed in 21 patients that had been treated with multiple pinning for femoral neck fractures, between October 1998 and October 2000. The uptake for each picture element was calculated, and an uptake ratio of fractured/intact sides determined. The patients were followed up for 2 years postoperatively, or until healing complications occurred.
Results: All 3 cases with a deficient femoral head uptake (ratio<1.0) developed hearing complications (2 AVN, 1 redisplacement). Of 18 cases with an intact femoral head uptake (ratio _ 1.0), only 2 developed complications (1 AVN, 1 redisplacement). The femoral head uptake ratio showed statistical significance relative to the healing complications. When the uptake ratio of the affected to normal parts was determined as 1.2, the prognostic accuracy and the sensitivity and specificity of the occurrence of complications all became 1.
Conclusion: The uptake ratio in a ",Tc-MDP bone scan, performed around 2 weeks postoperatively, can predict the outcome of the healing course. Therefore, this could be used as a guideline on follow up and for the treatment of patients with femoral neck fractures.
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KEYWORD
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Femoral neck fracture, Complications, (99m)^Tc-MDP bone scan, Quantitative analysis
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