Scintimetric evaluation of remodeling after bone fractures in man.

In a review of bone scans of 2000 post-trauma patients, the following rules of bone remodeling after fracture were found: different bones behave differently; lesions in the vicinity of joints show an early and high accumulation of the tracer within the first days after the trauma, whereas fractures of the axial skeleton and shafts of long bones sometimes need up to 12 days to appear on scan; all except skull fractures demonstrate a steady rise of accumulation intensity compared to normal bone for 2-5 wk; the steepness of increase and time of maximum differ significantly for different fracture sites. Calculating a ratio 24:4 hours after injection helps differentiate fractures from soft tissue lesions since fresh fractures show a ratio > 1:1. We found no clinically relevant dependence on sex and age.

[Clinical relevance of whole body skeletal scintigraphy in multiple injury and polytrauma patients].

The provision of care to polytraumatised patients is a particular diagnostic and therapeutic challenge. The examination data of 162 polytraumatised patients were retrospectively investigated to determine the diagnostic gain provided by skeletal scintigraphy with 99mTc-HMDP. It was found that every fresh fracture (with the exception of fractures to the skull) led to a scintigraphically clearly demonstrable remodelling reaction within ten to 14 days.

[The age dependence of traumatically induced bone remodeling as studied in the bone scintigram].

Two independent groups of patients were studied by bone scintigraphy to demonstrate age-dependent changes in the appearance time of fractures: 83 patients with 123 fractures of the spine showed neither by multiple regression analysis nor by separation into two subgroups (younger and older than 55 years) a clinically significant difference by scintimetric evaluation. A second group of 162patients with multiple trauma demonstrated no age dependence of the rate of additional bone lesions shown by scintigraphy. Instead a clear dependence on the site of the lesion and the time after trauma was found: fractures of the shafts of long bones and fractures of the pelvis and spine showed up significantly later than fractures in the neighbourhood of the distal joints.

[Experiences with the Spotorno expansion acetabulum].

At 53 hip joints a cupshell developed by L. Spotorno was practiced as replacement for the acetabular joint surface. This cementless CLS expansion-shell was always in combination with an also cementless femoral prosthesis applied in case of medial femur neck fractures, coxarthrosis, or the exchange operation to implantation.