The predictive value of bone scintigraphy after internal fixation of femoral neck fractures

Abstract Persisting pain of the hip following internal fixation of fracture of the neck of the femur is often caused by capital necrosis or non-union. In a randomized trial 35 patients had 99 Tc m -MDP bone scintigraphy performed 6 weeks, 3, 6 and 12 months after internal fixation of their subcapital fractures with a sliding screw-plate or a sliding nail-plate. The purpose was to find out whether bone scintigraphy could predict capital necrosis or non-union before it shows up on plain radiographs, which happens later. The patients were followed up for an average of 44 months (range 12–64). Radiologically, capital necrosis occurred in five patients and non-union in six. Bone scintigraphy showed decreasing activity in the 1st year after operation in uncomplicated cases ( P