[Osteonecrosis, alcoholism and liver steatosis]

Ethylism represents at the present time one of the most frequent etiological factors of primitive osteonecrosis of the femoral head. In relation to a case of osteonecrosis of the femoral head associated with multiple bone infarcts in a chronic alcoholic, also presenting recurring jaundice, alcohol-sensitive hyperlipidaemia, and moderate anaemia, the authors review the role of fatty embolisms in the formation of primitive osteonecrosis of the femoral head. These fatty embolisms may be the result of alcohol-induced hyperlipidaemia, possibly an associated pancreatic disorders, or in particular of hepatic steatosis. A systematic histological study of 10 recent unselected cases of primitive osteonecrosis of the femoral head confirmed the extreme frequency of such embolisms (8 cases out of 10).