Scintigraphical Observation of Femoral Head in Femoral Neck Fractures:Comparison with Histological Findings

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In IO cases of femoral neck fracture treated with prosthetic replacement, the preo perative 99mTc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head.The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of 99mTc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases.Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic.This classification of 99mTc-MDP scintigraphy is correlated with the degree of femoral head necrosis and it can be emphasized that the preoperative scintigraphy is a useful method to select osteosynthesis or prosthetic replacement treatment, etc.
西日本整形・災害外科学会の論文