Radiology, Vol 137, 53-56, Copyright © 1980 by Radiological Society of North America
Assessment of healing of long-bone fractures by intraosseous venography
HA Baltaxe, DD Shaw and JF Connolly
Intraosseous venography with compression of the soft tissue was performed
following fracture of the radius in 13 dogs to assess the repair process.
Two angiographic criteria were analyzed: (a) intraosseous venous crossing
of the fracture ("medullary crossing") and (b) capillary blush of the
proximal osseous fragment ("proximal blush"). The bone strength of the
fractured and intact radii was compared. Venograms obtained immediately
after fracture showed contrast material reaching but not crossing the
fracture line, indicating that the entire intramedullary venous network had
been disrupted. When Parafilm was interposed between the bone fragments to
prevent healing, proximal blush was seen at 4 weeks and medullary crossing
at 6-7 weeks; bone strength was 13-14% of normal. With no barrier, proximal
blush appeared at 5 weeks and medullary crossing at 10-11 weeks; bone
strength was 30-40% of normal. The authors conclude that medullary crossing
can be seen in the presence of decreased bone strength if the healing
process is uneven across the fracture line, as occurred with Parafilm. If
the animal model reproduces the clinical situation, this finding challenges
the predictive value of intraosseous venography.
