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Further Observations on the Use of Radioactive Phosphorus (P32) to Determine the Viability of the Head of the Femur CORRELATION OF CLINICAL AND EXPERIMENTAL DATA IN 130 PATIENTS WITH FRACTURES OF THE FEMORAL NECK
H. B. BOYD; R. A. CALANDRUCCIO
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From the Department of Orthopaedic Surgery, University of Tennessee College of Medicine and the Campbell Foundation, Memphis
1963 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1963; 45:445-460 
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Abstract

1. Since avascular necrosis inevitably develops in a certain percentage of patients with fractures of the neck of the femur because the blood supply of the head of the femur has been diminished as a result of the fracture, theoretically one should be able to predict shortly after fracture whether a given patient will have clinical evidence of avascular necrosis.

2. If the circulation of the head of the femur is interrupted, in vivo uptake studies reveal no uptake of P32 ninety minutes or more after injection.

3. Studies of uptake of P32 appear to be of prognostic value in two-thirds of patients with displaced fractures of the neck of the femur. In the group reported here, had these data been used as the deciding factor as to whether a prosthesis should be inserted primarily, an actual or irreversible error would have been made in approximately 10 per cent.

4. In a given patient, the experimental uptake study may not predict the clinical end result accurately either because of failure to obtain data from the weight-bearing area, or because of the presumably insurmountable obstacle presented by irregular isotope uptake in the head of the femur caused by partial interruption of the circulation.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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