J Korean Orthop Assoc.  2005 Apr;40(2):126-131.

The Role of Preoperative Bone Scan in Determining the Treatment Method of Femoral Neck Fracture

Affiliations
  • 1Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea. oskim@snu.ac.kr

Abstract

PURPOSE
To evaluate the role of a preoperative bone scan in determining the operative treatment methodof a femoral neck fracture. MATERIALS AND METHODS: Between January 2001 and December 2003, 62 out of 257 patients, who underwent a preoperative bone scan after a femoral neck fracture were included. The fractures was classified according to the stage of Garden. The uptake of the Tc-99m methylenediphosphonate (99mTc-MDP) isotope was estimated visually, and categories as -2 (the femoral head activity in the fractured side is general reduction compared with the opposite side), -1 (the activity is partial reduction), 0 (the activity is normal) and 1 (the activity is general increase ). RESULTS: 62 patients, 17 male and 45 female, with a mean age of 67.4 years (range 18 to 93) were investigated. Of the 19 patients with Garden stages I and II 17 were 0, and 1 each were -1 and -2. Eighteen patients were operated on with multiple pinning, and 1 with bipolar hemiarthroplasty. Of the 43 patients with Garden stages III and IV 37 were -2, 4 were -1 and 2 were 0. Thirty-eight patients were operated on with bipolar hemiarthroplasty. Four patients were operated on with total hip arthroplasty. One patient was operated on with multiple pinning. The operative method was changed in only 1 of the 62 patients due to the bone scan finding. CONCLUSION: The isotope uptake of the preoperative bone scan after a femoral neck fracture generally corresponded with the degree of fracture displacement. Therefore, a preoperative bone scan seems to play no significant role in determining the operative treatment method of a femoral neck fracture.

Keyword

Femoral neck fracture; Bone scan

MeSH Terms

Arthroplasty, Replacement, Hip
Female
Femoral Neck Fractures*
Femur Neck*
Head
Hemiarthroplasty
Humans
Male
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