Vascularized bone transfer: evaluation of viability by postoperative bone scan

Postoperative assessment of the viability of vascularized bone transfer was done in 23 patients by using radionuclide imaging within the first postoperative week. Follow-up ranged from six to 45 months. The results of bone scans in the region of the vascularized bone transfer were positive in 16 patients. Of these, over 60 percent went on to uncomplicated union and a successful clinical outcome, with no frank failures. The results of scans were negative or equivocal in seven patients. Only 1 of these went on to uncomplicated healing and two cases (almost 30 percent) resulted in frank failure, necessitating removal of the transferred bone. Radionuclide imaging in the first postoperative week after vascularized bone transfer appears to be a useful monitor and prognostic indicator of the subsequent clinical course.