INTERTROCHANTERIC FRACTURES OF THE FEMUR IN RHEUMATOID-ARTHRITIS PATIENTS

In a series of 33 intertrochanteric femoral fractures in patients suff ering from classic rheumatoid arthritis (RA), the typical patient was about 70 years of age, osteopenic, and severely affected by longstandi ng polyarticular RA of joints other than the hip. Prefracture involvem ent of the hip joint (other than osteopenia) was apparent radiographic ally in only 9.1% of patients. There was a higher rate of avascular ne crosis (9.7%) and nonunion (6.5%) than expected in the nonrheumatoid g eneral population. There was also a high rate of secondary displacemen t. Of three patients with avascular necrosis, two had had corticostero id treatment.