tetracycline and Hip-Fractures

We performed single-photon-emission CT (SPECT) and planar bone scans to assess femoral head vascularity in ten patients with displaced intracapsular hip fracture. The heads were labelled with tetracycline and after excision at hemiarthroplasty were assessed for tetracycline uptake distribution by fluorescence under UV light. The four which had the greatest tetracycline uptake were normal on SPECT and planar imaging. In two cases the planar bone scans were normal although SPECT suggested avascularity thus giving false-negative results. Surgeons should be aware of this; SPECT may prove to be a more accurate method of assessing vascularity of the femoral head in fractures of the femoral neck.

Topics: Arthroplasty; Femur Head; Hip Fractures; Humans; Technetium Tc 99m Medronate; Tetracycline; Tomography, Emission-Computed, Single-Photon

The study was done to determine femoral head vascularity in the immediate postfracture stage as assessed by 99m Tc-sulphur colloid bone scanning and tetracycline uptake in the excised femoral heads of 30 patients with subcapital fractures treated by primary hemiarthroplasty. Twenty-four cases were diagnosed avascular by the scan, and this was confirmed by the absence of tetracycline labelling in all 24. Two cases were vascular by the scan, and this was confirmed by tetracycline labelling. The scan was inaccurate in only four cases, where the head appeared vascular by the scan, but avascular by tetracycline labelling. Sulphur colloid is helpful in predicting femoral head vascularity in the immediate postfracture phase.

Topics: Femur Head; Fluorescence; Fluorescent Dyes; Hip Fractures; Hip Prosthesis; Humans; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tetracycline; Time Factors