technetium-tc-99m-medronate and Radius-Fractures

Topics: Adult; Humans; Humerus; Male; Radionuclide Imaging; Radiopharmaceuticals; Radius Fractures; Sternum; Technetium Tc 99m Medronate

A 24-year-old female gymnast had a 3-month history of bilateral forearm pain. A Tc-99m MDP bone scan demonstrated focally increased activity in the radial shafts on blood pool and delayed images, characteristic of fatigue fractures. Fatigue fractures commonly occur in the lower extremities. Upper extremity fatigue fractures, in contrast, are uncommon and usually involve the humerus or ulna. Fatigue fracture of the radial shaft from gymnastic exercise has not been previously reported.

Topics: Adult; Female; Fractures, Stress; Gymnastics; Humans; Radionuclide Imaging; Radius Fractures; Technetium Tc 99m Medronate

In addition to its established oncological indications the sensitivity of bone scintigraphy is of steadily increasing significance in traumatology. Inactivity-induced osteoporosis plays a major role during the immobilization period in the plaster cast. In the region of the joints remodelling intensity may reach such a high level that the non-injured bone shows a higher rate of accumulation than the fracture. This process already begins between the third and fourth week of immobilization. The highest uptake is found after fracture of the scaphoid bone at the end of twelve weeks of immobilization. Control scintigraphies at intervals of several days are indicated to differentiate between various clinical conditions (pseudoarthrosis, activated osteoarthrosis, algodystrophy in case of doubtful x-ray results).

Topics: Carpal Bones; Fracture Fixation; Fractures, Bone; Humans; Osteoporosis; Radionuclide Imaging; Radius Fractures; Technetium Tc 99m Medronate

Mid-shaft fractures of the radius and ulna were produced in 3 to 4 kg New Zealand white rabbits and quantitative uptake of 99mTc MDP and 67Ga determined at 11, 18, 25, 32, 51, and 78 days following fracture. Two hundred microCi of 67Ga was administered 24 hours prior to sacrifice and 1.5 mCi 99mTc MDP 2 hours prior to sacrifice. Specific activity ratios (SARs) were determined between fracture and control sides for bone, muscle and skin. SARs for bone were surprisingly similar for 99mTc MDP and 67Ga, reaching peak values of 6.07 +/- 0.64 (99mTc 18 days); 6.58 +/- 0.90 (67Ga 32 days), subsequently decreasing to minimum values at 78 days postfracture (99mTc MDP 2.25 +/- 0.14; 67Ga 2.18 +/- 0.08). There was no statistically significant difference in SAR for 99mTc MDP vs. 67Ga in bone at any time after fracture. Whole sections of limb were resected on selected animals and activity ratios determined for these sections as a function of the contribution of activity from the various tissues in the volume of interest. Total activity ratios of 67Ga were lower than bone SARs as a result of the contribution of activity from muscle and skin. Thus the apparent lower activity ratios noted on 67Ga images compared with 99mTc MDP images in this fracture model were not due to differences in bone SARs but rather due to the higher soft tissue background activity contribution in the 67Ga images.

Topics: Animals; Fractures, Bone; Gallium Radioisotopes; Rabbits; Radionuclide Imaging; Radius Fractures; Technetium Tc 99m Medronate; Ulna Fractures

Topics: Animals; Papio; Radionuclide Imaging; Radius Fractures; Technetium Tc 99m Medronate; Ulna Fractures; Wound Healing

This randomized, controlled study was performed to evaluate how electromagnetic fields affect the accumulation of 99mTechnetium - methylendiphosphonate (Tc-MDP) in fresh fractures. Thirty women with Colles' fractures, aged 50-70 years, participated in this study--some in a control group and some in a treated group. After reduction, all patients were immobilized for four weeks. After randomization, 15 patients were treated by electromagnetic fields of extremely low frequency (EMF of ELF ), which were generated by a coil and a battery-powered portable current generator during the time of immobilization. The frequency of the alternating magnetic field was 1-1000 Hz; the magnitude was 4 gauss [RMS (root-mean-square) value]. The scintigrams were performed one, two, four, and eight weeks after the injury. The activity ratio in the fracture area was significantly higher at the examination of one and two weeks (p less than 0.05, p less than 0.01) in the treated group than it was in the control group. The clinical relevance of the results is not known, but one interpretation of the data is that the stimulation with EMF of ELF improves (accelerates) the early phase of fracture healing. The data warrant further investigation of fresh fracture treatment with this method.

Topics: Aged; Colles' Fracture; Diphosphonates; Electric Stimulation Therapy; Evaluation Studies as Topic; Female; Humans; Magnetic Field Therapy; Middle Aged; Radius Fractures; Random Allocation; Technetium; Technetium Tc 99m Medronate; Wound Healing

Serial bone scannings with 99-M-Tc-MDP have been performed in 15 patients with an extra-articular dorsal-angulated fracture of the distal radius (Colles' fracture). A method for the quantification of healing activity is described. The activity-ratios show a typical pattern of progress during the healing period. There is a correlation between fractures with high activity ratios late in the healing period and fractures that redisplace during the healing period.

Topics: Aged; Colles' Fracture; Computers; Diphosphonates; Female; Humans; Middle Aged; Radionuclide Imaging; Radius Fractures; Technetium; Technetium Tc 99m Medronate; Time Factors; Wound Healing

The assessment of bone healing through sequential nuclear medical scintigraphy requires a method of consistent localization of the exact fracture area in each consecutive image as the study progresses. This is difficult when there is surrounding bone activity as in the early stages of trauma, and also if complications should set in. The image profile feature, available from most nuclear medical computer software, facilitates this procedure considerably, as is indicated in the present report on bone healing in baboons. Together with roentgenology and histology a 99mTc-MDP study was in this way successfully done on the healing of long bone fractures experimentally induced in non-human primates. Different surgical implants were used. The results indicate that 99mTc-MDP accurately reflects the physiological activity in bone. The time-activity curves obtained are presently being studied together with extensive histology, bearing possible clinical application in mind.

Topics: Animals; Diphosphonates; Fractures, Bone; Fractures, Closed; Papio; Radionuclide Imaging; Radius Fractures; Technetium; Technetium Tc 99m Medronate; Ulna Fractures; Wound Healing