Intraosseous Venography for the Early Union Detection of the Femoral Neck Fracture

Kim, Key Yong; Cho, Duk Yun; Kim, Young Tae; Moon, Seong Cheol

Abstract

In spite of highly advanced technology in orthopaedic field, management of femoral neck fracture presents difficult problems due to frequent non-union or avascular necrosis of femoral head even with adequate treatments. Intracapsular fracture of the femoral neck heals in the same way as other intra-articular fractures only by endosteal and not by periosteal repair. Avascular necrosis occurred in one-third of displaced fractures with more than a two-year follow-up and is the most serious remaining factor affecting the result. Many attempts have been made to achieve early diagnosis of nonunion and avascular necrosis of the femoral head. Yet, there is still no reliable clinical method of early detection of the union of femoral neck fracture and the viability of the femoral head. For the early detection of union and viability of femoral head, we performed femoral trochanteric intra-osseous venographic technique. Intraosseous venography was performed in 19 cases of femoral neck fractures in the orthopaedic department of National Medical Center during the period from Jan. 1979 to Dec. 1981. The results were as follows: l. 19 patients of femoral neck fracture were performed osteomedullography. Intra-osseous venous flow across the fracture line was seen in 11 cases from 19 patients. 2. Intra-osseous venous flow across the fracture line was seen between the 6th and 12th week following fracture treatment in rigid fixation and adequate reduction. 3. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing and non-union.