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To the Editor:—
Twenty years ago femoral neck necrosis following irradiation of the female pelvis for cancer was not rare and could be excused in those practitioners whose training antedated the modern teaching of radiation therapy. Today, no such excuse is valid, or fair to the public. In fact, it is shocking to read in The Journal, Jan. 21, p. 204, that 24 postirradiation fractures of the femur can be collected at the Mayo Clinic. Praise be to them for successful treatment. Perhaps they will assist in broadcasting to their far-flung physician contributors a message:Pelvic x-radiation, whether administered by radiologist or gynecologist, should be given only after careful and accurate localization of portals (by fluoroscopy or test films) and placement of protective lead blockers over the femoral heads and necks. I know this can be done with safety, because our program has used for 15 years one of the
Lame EL. Post-Irradiation Fractures. JAMA. 1961;176(6):549-550. doi:10.1001/jama.1961.03040190071023