SEQUENTIAL SCINTIGRAPHY AND ORTHORADIOGRAPHIC MEASUREMENT OF FEMORAL SHORTENING AFTER FEMORAL-NECK FRACTURE

The objective of the study was to assess scintigraphic patterns and fe moral shortening after femoral neck fracture in order to select predic tive parameters for late complications. Eighty-eight patients with ost eosynthesized femoral neck fractures were followed for 2 years with re gular scintigraphic evaluations and orthoradiographic measurements of femoral length shortening. Four different patient categories were iden tified with regard to the late outcome: two different groups with unev entful healing and two different groups with late complications. Accor dingly, a high scintigraphic uptake at 1 month may either point to an uneventful healing if combined with minor femoral shortening or indica te failure if combined with a high degree of femoral shortening. In co ntrast, low scintigraphic uptake may either reflect primary fracture h ealing if accompanied by minor femoral shortening or predict failure i f a high degree of femoral shortening is present. Compared with using scintigraphy alone, combined scintigraphic evaluation and assessment o f femoral shortening increased the accuracy for prediction of late fai lures from 80% to 93%. Early scintigraphic patterns after osteosynthes is of femoral neck fractures have to be validated with care. Radiograp hic assessment of femoral shortening, which is less invasive, gives be tter prognostic accuracy and should therefore be preferred for this pu rpose.