Abstract
Twenty five femoral neck fractures in 24 patients with rheumatoid arthritis (RA) are reported on.
The patients were one male and 23 females, with an age distribution of from 35 to 78 (average 64) . By Steinbrocker's stage classification the majority of the cases were stage III and IV because of advanced RA. Their ADL was class III according Steinbrocker's class classification. Those patients with fractures usually had accompanying joint impairments in the lower extremities, especially in the knee jont, and advanced osteoporosis as well.
The sites of the femoral neck fracture were the subcapital region in 76% and the trochanter region in 24%. Seven cases out of 19 subcapital fractures had spontaneous fracture.
Six cases of trochanteric fracture showed favorable bone union, except for one case which was revealed to have had the bone cut off by the lag screw. On the other hand, the 5 cases with subcapital fracture showed poor results during conservative treatment as well as after osteosynthesis. Four of these developed pseudoarthrosis and osteonecrosis of the bone. Forteen cases received hip replacement surgery immediately after the fracture, and good results were obtained.
