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Determination of Bone Blood Supply with Tc-99m Red Blood Cells and In-113m Transferrin in Fractures of Femoral Neck: Concise Communication

Sjukhuset, Östersund, Sweden

Correspondence: For reprints contact: V. Kempi, Dept. of Radiophysics, Sjukhuset, S-831 83 Östersund, Sweden.

ABSTRACT

The uptake of in vivo labeled Tc-99m RBCs and In-113m transferrin was studied in femoral bone of 21 patients who had recent operations for fracture of the femoral neck. Femoral bone biopsies and blood samples were obtained during the operation. The activity values for bone biopsies, erythrocytes, and serum were determined, and the uptake ratios between bone and erythrocyte cpm/g and between bone and serum were calculated. Biopsy samples were taken from the femoral head in 21 cases and from the trochanteric region in 14. The activity ratios for the two tracers correlated well: r = 0.94 for femoral head biopsies (P <0.001) and r = 0.98 for samples from the trochanteric region (P <0.001). Thus, the procedures are interchangeable and either may be valuable in assessing bone blood supply. An additional patient, studied only with Tc-99m RBCs, had a subsequent operation for nonunion of a fracture. Samples of both cancellous and cortical bone were obtained from the removed head. The activity ratios for the two types of bone tissue differed significantly (P = 0.02).