Er. Bogoch et al., INTERTROCHANTERIC FRACTURES OF THE FEMUR IN RHEUMATOID-ARTHRITIS PATIENTS, Clinical orthopaedics and related research, (294), 1993, pp. 181-186
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.