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PubMedDate not supplied

[Early diagnosis by scintigraphy of femur head necrosis after femur neck fracture].

Necrosis of the head of the femur with segmentary collapse after transcervical fractures occurs in 30 to 50% of the cases. Diagnosis of avascular necrosis should be made early before the head collapses. In a clinical and experimental study, we attempted to perform early screening for this complication. We studied 41 fractures of the neck of the femur with technitium scintigraphy with intravenous injections and compared uptake in pathological and normal heads. In the first group of 20 cases of fresh fractures, scintigraphy was performed before operation then repeated every three months to the 36th months later. High uptake we seen in 12 of the 20 cases then returned to normal 12 to 18 months later. Consolidation occurred in all 12 without necrosis. In 8 cases uptake was low initially then rose greatly and remained higher than normal. Necrosis occurred in 6 of these 8 cases. In a second group of 21 patients with a history of necrosis of the head of the femur, uptake was high. Pathologic examination of the surgical specimen after resection for prosthesis showed cell growth around the zone of necrosis. In conclusion, this technique, when possible, would appear to be highly useful to screen for necrosis early.

Female↗
PubMed1984

[Value of radiological diagnosis in the complex study of femur head necrosis in children. 1. Plain film and arthography in the framework of complex studies of femur head necrosis].

The results of complex investigations of case history, clinical methods, plain film radiology, laboratory findings, arthrography, histology, scintigraphy, and angiography give information of the picture of necrosis of the femoral head ossification center. Especially from the radiological diagnosis conclusions can be drawn for secondary prevention, diagnosis, prognosis, and therapy.

Adolescent↗
PubMed1984

[Value of radiological diagnosis in the complex study of femur head necrosis in children. 2. Scintigraphic and arteriographic studies in the framework of the complex diagnosis of femur head necrosis].

101 scintigraphic investigations and 42 angiograms show that the vascular tamponade is the decisive factor for the beginning of necrosis of the femoral head ossification center. Plain films, scintigraphy and angiography give information of the duration of the disease. Extent and localisation of the circulatory disturbance are important for the prognosis of the disease. From stage classification and prognostic factors the conclusions for therapy can be drawn.

Adolescent↗
PubMedDate not supplied

[Comparative studies on cadmium, chromium, nickel and lead accumulation in coxarthrosis and idiopathic femur head necrosis].

Possible heavy-metal toxicity due to cadmium, chromium, nickel and lead in coxarthrosis and idiopathic necrosis of the head of the femur is reported on for the first time. Studies are made in the diseased head of the femur by means of ICP emission spectroscopy and atom absorption spectrophotometry. Whereas the blood and bone analyses in the own control group and in the coxarthrosis patients show normal values, a statistically significantly elevated element concentration in the head of the femur in the case of idiopathic necrosis of the head of the femur could be demonstrated with regard to the heavy-metal toxicity due to cadmium, nickel and lead. The analysis of the necrotic zone itself also shows considerable accumulations both for chromium and for nickel and lead. Since the analysed trace elements are strongly toxic in high concentrations, further clarification of a possible causal relationship between toxic trace element concentration and idiopathic necrosis of the head of the femur appears necessary.

Adult↗
PubMed1991

[Superselective intra-arterial DSA in femur head necrosis and femoral neck fractures].

The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA--after pedicled pelvic bone graft--revealed a regular arterial graft perfusion in 82%.

Adult↗