Serial quantitative Tc-99m-MDP uptake measurement of femoral head, neck and trochanteric region by pixel counting with I.M.A.C. 7310 computer were performed in 27 cases of femoral neck and 13 cases of femoral trochanteric fractures that were clinically, radiographically and scintimetrically followed from Jan. 1984 to Jun. 1985.
The results obtained were as follows:
1. In femoral neck fractures group, the mean uptake ratio of femoral head was 0.91 0.12 at 1 week after injury, 1.140.21 at I month and 1.160.13 at 18 months, and the mean uptake ratio of femoral neck 2,160.72 at 1 week after injury, 3.531.89 at 1 month and 2.77-1.58 at 18 months, and the mean uptake ratio of femoral trochanter was 2.030.34 at 1 week after- injury, 1.380.10 at 8 months and 1.750.25 at 18 months.
2. In femoral trochanteric fractures group, the mean uptake ratio of femoral head was 1. 220.07 at 1 week after injury, 1. 640. 32 at 4 months and 1. 360.28 at 18 months, and the mean uptake ratio of femoral neck was 2.060.27 at 1 week after injury, 1.790.43 at 4 months, 2.50 0.40 at 12 months and 2. 320.34 at 18 months, and the mean uptake ratio of femoral trochanter was 2.330.76 at 1 week after injury, 4.681.75 at 1 month and 2.420.32 at 18 months after injury.
3. In the femoral neck fractures group, the mean uptake ratio of femoral head in 7 complicated cases was 0.950.10 at 1 month after injury, 0.810.07 at 4 months and 1.26 0.14 at 18 months, and the mean uptake ratio of normal union group was 0.950.11 atI
week, 1.220.24 at 1 month and 1.100.09 at 18 months.
The above experimentation confirms that, in the cases of the uptake ratio with Tc-991n-MDP of tLe femoral head below the level of 1.0 at 1 week and up to 1 month after injury, it is reaso;;ably predictable that the complications such as necrosis and/or segmental
collapse of the femoral head i;,c.uld be certain to follow far before the radiological findings become apparent.
|