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Dr Brims
Dr Brims, U.S. Licensed Physician
Category: Medical
Satisfied Customers: 9616
Experience:  MD
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Gunshot wound to R leg, (my son)fractured femur-communitated

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Gunshot wound to R leg, (my son)fractured femur-communitated with ORIF(not from bullet hitting bone but force of shot) Intramedullary nail extending thru shaft held with prox&dist fixation screws. Can you define in laymans terms the following results of bone scans and their implications please. Active heteroscopic bone formation. Blood flow & pool images of femur showed intense increased blood pooling R mid femur extending into adjacent tissues. Exuberant callus formation extending around fracture. Lucency adjacent to the lateral cortex with absent callus formation but with surrounding rim of callus formation. Sorry it's so long. Thankyou and regards. Rod
Submitted: 5 years ago.
Category: Medical
Expert:  Dr Brims replied 5 years ago.
Hello, welcome to Justanswer, I will try to assist you with your medical question, and any medical information you seek

This means there is bone growth in the soft tissue (likely muscles)
There is increased blood flow to the tissue next to the femur (this is expected)
There is a lot of new bone growth around the fracture
Small area at the fracture shows no bone growth, but it is surrounded with a rim of new bone formation

Basically the fracture is showing signs of healing, that is the bot***** *****ne
Customer: replied 5 years ago.

Thank you Doctor.

I know the meaning of heterotopic but could you explain the long term problems or effects of this please.

Is the increased blood flow and pooling good or bad?

Is the bone growth around the fracture good or bad?

The small area of the fracture shows no bone growth - is this good or bad and is the rim of new bone a satisfactory substitute?

The injury occurred on Oct 29/30 2011 and the scans were conducted in early March 2012. He had about 30 degree knee movement but has improved to over 100 degs with physio and brute force (under general anesthetic) - caused by calcification of knee joint due to inactivity/long time before operation to insert rod into femur



Expert:  Dr Brims replied 5 years ago.
If the heterotopic bone is far from the normal bone it may cause pain in the future, the fact that they said heterotopic bone doesn't mean much since they did not describe where it is

Increased blood flow is good

Bone growth around the fracture is good

The small area with no bone growth is good, the rim of new bone may be a satisfactory substitute, but I would have to see the x ray to know if it definitely is or not
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Customer: replied 5 years ago.
Thanks Doctor, I can't add any more, I don't have any xrays with me and my son is over 2000 miles away. There is one other note on the reports that appears to refer to a previous fracture of the femur (He didn't tell me about that although he did fracture/dislocate his R ankle some years ago) This reads 'Intensley increased isotope accumulation was seen at and adjacent to the site of previous R femoral fracture at the junction of prox. 2/3rd with dist. 1/3rd, this extends along femoral shaft and into adjacent soft tissue'. Not sure if this is of any use. Regards, Rod
Expert:  Dr Brims replied 5 years ago.
Thank you, ***** ***** about the old fracture does not change anything with regards ***** ***** new fracture and its healing