Anatomico-radiological study of an ununited intracapsular fracture of the femoral neck dating back 47 years

Abstract

This is the anatomico-radiological study of a 47-year-old ununited intracapsular fracture of the hip. The femoral head was osteoporotic but its center contained a zone of osteomedullary necrosis in the form of a bone infarct. Its contour was reshaped and remnants of articular cartilage were covered by osteophyte-like bone formations; furthermore, an acetabular osteophyte was observed. Histological signs of Paget's disease of the bone were observed in the medial part of the femoral stump. The findings in this case provide the basis for a discussion of the pathogenesis of osteophytes in osteoarthritis, the pathogenesis of bone infarcts (and the distinction between this condition and another form of aseptic osteonecrosis), and the role of mechanical stresses in the development of Paget's disease of the bone.