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Early postoperative three-phase Technetium-99 m bone scanning predicts traumatic osteonecrosis in patients with femoral neck fractures: a 2- to 6-year follow-up study.

Created on 12 Sep 2025

Authors

Guangmin Yang, Shiye Huang, Deqing Liu, Ye Yuan, Yangyang Yu, Yan Li, Zuoxiang He, Yongwei Pan, Zhe Zhao

Published in

Archives of orthopaedic and trauma surgery. Volume 145. Issue 1. Pages 446. Sep 12, 2025. Epub Sep 12, 2025.

Abstract

This study aimed to explore the predictive value of early postoperative TPBS on post-traumatic osteonecrosis of the femoral head (ONFH) in femoral neck fracture (FNF) patients after internal fixation.
This study retrospectively reviewed the FNF patients who underwent TPBS within 72 h after internal fixation from January 2017 to December 2020 in our institution. All Patients were divided into ONFH and non-ONFH groups during the follow-up, and diagnostic analysis was used to assess the predictive value of TPBS on ONFH occurrence.
Fifty-one patients (51 hips) were included, with a mean follow-up of 4.7 years, ranging from 2.3 to 6.7 years. Twenty-one out of 51 patients showed femoral head perfusion defects on the postoperative TPBS, and 15 of the 21 patients developed ONFH in the follow-up. The sensitivity, specificity, positive predictive value, and negative predictive value of TPBS are 93.75%, 83.33%, 71.43%, and 96.77%, respectively. The semi-quantitative analyses showed that the tracer uptake in the lateral and medial pillars of the femoral head in the ONFH group was significantly reduced compared with the contralateral side. In contrast, the uptake in the medial, central, and lateral columns of the fracture side in the non-ONFH group was significantly higher than those on the contralateral side.
The present results found that early postoperative TPBS showed high sensitivity and specificity in predicting posttraumatic ONFH for the FNF patients after internal fixation and has considerable value in estimating the future risk of ONFH.

PMID:
40938444
Bibliographic data and abstract were imported from PubMed on 12 Sep 2025.

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