Limited Use for Bone Scintigraphy in the Follow-Up of Pediatric Femoral Neck Fractures
Volume 3 | Issue 1 | Jan-Jun 2017 | Page 12-15 | Samuel K. Van de Velde, Jack Pang, Lachlan Milne, Jitendra Balakumar
Authors : Samuel K. Van de Velde [1], Jack Pang [1], Lachlan Milne [1], Jitendra Balakumar [1].
[1] Department of Orthopaedics, The Royal Children’s Hospital Melbourne, Parkville (VIC) 3052, Australia
Address of Correspondence
Dr. Samuel K. Van de Velde,
Department of Orthopaedics, The Royal Children’s Hospital Melbourne
50 Flemington Road, Parkville (VIC) 3052, Australia
Email : svandevelde@post.harvard.edu
Abstract
Purpose: Femoral neck fractures in children are rare injuries which are associated with a high incidence of osteonecrosis of the femoral head. We aimed to determine the predictive accuracy of bone scintigraphy for femoral head osteonecrosis after pediatric femoral neck fractures.
Materials and Methods: Thirteen scintigrams were performed in 10 children (6–15 years) at diverse moments after fixation of a femoral neck fracture.The results of the bone scintigrams were compared with the hip radiographs at final follow-up.
Results: Eight of the 10 femoral heads eventually developed osteonecrosis. Scintigrams performed within 2 weeks showed decreased uptake for these heads. However,four of the five scans that were performed more than 1 month after surgery showed normal uptake despite the subsequent collapse of these femoral heads.
Conclusions: Bone scintigraphy has a very low accuracy in predicting compromised vascularity of the femoral head when performed more than 1month after surgery of a femoral neck fracture in children. This findingquestions the value of scintigraphy performed late in the follow-up of pediatric femoral neck fractures.
Level of Evidence: Level IV.
Keywords: Pediatric Hip Fracture; Bone Scan; Outcome
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| How to Cite this Article: Van de Velde SK, Pang J, Milne L, Balakumar J.Limited Use for Bone Scintigraphy in the Follow-Up of Pediatric Femoral Neck Fractures. International Journal of Paediatric Orthopaedics Jan-June 2017;3(1):12-15. |
