Osteomedullography for early diagnosis of the fracture healing, nonunion and avascular necrosis

Complications of non-union and avascular necrosis during fracture healing process are the most improtant problems. Early detection of the evidence of non-union and avascular necrosis and follow-up study of fracturehealing process will reduce complications and sequellae in fracture patients. Femoral neck and tibial shaft arethe most important fracture sites where non-union and /or avascular necrosis are frequently developed. Osteomedullography was performed in 30 cases of fracture, 21 femoral neck, 8 tibial shafts and 1 talar neck, inthe Departmemt of Radiology of national Medical Center during the period from August 1977 to March 1981. The following results were obtained; 1. 16 patients of femoral neck fracture were perforemd osteomedullography once. Non-union showing no crossing vein through the fracture site was noted in 12 cases from 16 patients. 4 cases fromthe 12 patients of non-union showed decreased viability but 2 case revealed good viability of the femoral head. 1case from 4 cases of good union of fracture showed no evidence of viability of the fmoral head. 2, More than twiceof osteomedullography were performed in 5 cases of femoral neck fracture, and crossing vein was not appeared in 4cases at 3 weeks after fracture. 3 cases showed crossing veins at 6 weeks, and 1 case revealed evidence ofavascular necrosis of the femoral head at 9 weeks. 3. In 8 cases of tibial shaft fracture, 4 cases were non-union.Another 4 cases revealed intraosseous veins crossing infracture site or additional Kaski's osteomedullographicsigns, indicating bony union. 4. One talar neck fracture showed bony union with decreased viability of the body on 12 months after fracture. 5. Osteomedullography is considered as very important study for the early diagnosis ofthe fracture healing, non-union and avascular necrosis.