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Role of Bone Scintigraphy in the Evaluation and Treatment of Nonunited Fractures: Concise Communication

Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Correspondence: For reprints contact: Abass Alavi, MD, Hospital of the Univ. of Pennsylvania, Nuclear Medicine Section, 3400 Spruce St., Philadelphia, PA 19104.

ABSTRACT

Seventy-seven patients with nonunited fractures underwent percutaneous low-grade, direct-current stimulation; the response was correlated with the scintigraphic findings obtained before the treatment. Two distinct patterns of osseous activity were noted: those with intense activity at the fracture site (Group 1) and those with a line of decreased activity surrounded by increased uptake on both sides (Group 2). The scintigrams that did not fit into either of the two patterns were considered as indeterminate (Group 3). Whereas 95% of the patients in Group 1 showed an excellent response to electric stimulation, none of the patients in Group 2 had evidence of healing. The response rate in the third group was 50%. On the basis of these preliminary data, bone scintigraphy is recommended as an important initial examination for the proper selection of patients for percutaneous electric stimulation.