The use of three-phase bone imaging in vascularized fibular and iliac bone grafts

Three-phase bone imaging was undertaken to monitor the viability of vascularized bone grafts after surgery. Eleven vascularized fibular grafts and six vascularized iliac grafts were reviewed. The study evaluated patients over multiple time intervals from 1 week to 6-8 weeks postoperatively. Follow-up ranged from 12 to 60 months. In most of the patients who achieved a successful clinical outcome, the study was positive; blood perfusion and blood pool radioactivity at sites of bone grafts were higher than those at recipient sites two weeks postoperatively and became equal to surrounding tissue thereafter. The grafted bone uptake of radiophosphate was constantly positive in these cases. Conversely, the study was negative in three cases of postoperative vascular complications. Serial three-phase bone imaging is a useful tool to monitor the viability and early complications of vascularized bone grafts after surgery.