Spontaneous fractures of the femoral neck

Abstract

Aching pain in the thigh, hip, buttock, or knee in an elderly person should lead to radiological examination of the hip joint. In patients who have been subjected to irradiation for pelvic neoplasms, spontaneous fractures should be strongly suspected and the patient kept under close review, even if the first radiograph is negative. Patients with spontaneous fractures of the femoral neck can be satisfactorily treated by Smith Petersen nailing even when symptoms have been present for as long as 16 wk and displacement for eight wk. Prosthetic replacement using a Thompson prosthesis cemented into the femoral shaft is a satisfactory alternative treatment when reduction cannot be achieved and can also be used if internal fixation proves ineffective. (12 references.)