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October 1960

Spontaneous Femoral Neck Fracture Following Pelvic Irradiation: Report of Three Cases

Author Affiliations

From the Departments of Orthopaedic Surgery, Michael Reese Hospital and Northwestern University Medical School, Chicago.; Assistant Professor, Department of Orthopaedic Surgery, Northwestern University Medical School, and Chairman, Department of Orthopaedic Surgery, Michael Reese Hospital (Dr. Finder); Senior Resident, Department of Orthopaedic Surgery, Michael Reese Hospital (Dr. Post).

Arch Surg. 1960;81(4):545-552. doi:10.1001/archsurg.1960.01300040029006

Introduction  Treatment of femoral neck fracture complicating carcinoma of the pelvic region may have a good prognosis if the fracture is produced by irradiation and not by metastasis. The diagnostic portent of differentiating between the two causes is at once obvious. While the irradiation fracture may pose a serious and even difficult orthopedic problem, it does not carry the grave implications to life and limb that attend the pathologic fracture from metastatic cancer. Although recent literature contains a number of reports of irradiation fractures, the emphasis has been placed on pathogenesis and pathology; little has been said about differential diagnosis and surgical treatment.Spontaneous fractures of the femoral neck occurring after a variable time interval following pelvic irradiation have been documented repeatedly since 1927 when Baensch1 first reported the condition. However, in the past insufficient emphasis has been placed on the need for diagnostic awareness of irradiation fractures. The

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