Complications and imaging artifacts related to MRI in patients with intramedullary osteosynthesis after proximal femur fracture

J Orthop Surg (Hong Kong). 2019 Sep-Dec;27(3):2309499019879055. doi: 10.1177/2309499019879055.

Abstract

Background: Fractures of the proximal femur is one of the most frequent human injuries, and most of the patients are treated with osteosynthesis, such as intramedullary nails. These patients often require magnetic resonance imaging (MRI) scans in their further lives due to various reasons. This raises the question of whether complications with implanted osteosynthesis material such as implant loosening, burning, dislocation, or other complications are to be expected or whether an MRI examination is even suitable with regard to imaging artifacts.

Methods: The aim of this retrospective study was to investigate the rate and type of complications after MRI examinations in patients with inserted intramedullary osteosynthesis device. Furthermore, artifacts in MRI caused by this device were assessed.

Results: MRI scans of the head (20 of 62), spine (20 of 62), pelvis (10 of 62), and lower extremity (6/62) were performed. Three of the 62 patients received an MRI of the abdomen, and 2 of the 62 patients received an MRI of the thorax and the upper extremity. Of the 62 patients, noneexperienced complications during the immediate examination. Similarly, none of the patients showed early complications within the first 2 weeks after MRI. In our long-term follow-up examination, no long-term complication after MRI was observed in the recorded 15 patients. Artifacts were found in 14 patients: in MRI scans of the pelvis (10/10), of the abdomen (2/3), and of the lower extremity (2/6).

Conclusion: There were no complications during the MRI scan, in the first 2 weeks after MRI, or in the recorded long-term results. MRI with an enclosed intramedullary nail provided good image quality unless the immediate implant site was imaged. MRI diagnosis is thus possible in patients with an inserted intramedullary nail. The inserted intramedullary nail should therefore not be an exclusion criterion when sectional imaging with MRI is required.

Keywords: femoral neck fracture; gliding nail; intramedullary nail; magnetic resonance imaging (MRI); nailless osteosynthesis; proximal femoral fracture; sectional image diagnostics.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Artifacts*
  • Bone Nails / adverse effects*
  • Bone Screws / adverse effects*
  • Female
  • Femoral Fractures / diagnosis*
  • Femoral Fractures / surgery
  • Fracture Fixation, Intramedullary / adverse effects*
  • Fracture Fixation, Intramedullary / methods
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Reproducibility of Results
  • Retrospective Studies