Hip fracture in rheumatoid arthritis

All patients with rheumatoid arthritis, admitted for hip fracture to a regional hospital during a 5-year period, were studied in retrospect. Of 1092 hip fractures, 16 cervical and nine trochanteric fractures occurred in rheumatics. Four cervical fractures were stress fractures. The mean patient age was lower than in a normal hip fracture material and the female predominance more pronounced. Of 14 surviving patients with cervical fractures, three had an uncomplicated 2-year healing, while 11 developed redisplacement, non-union or segmental collapse, in eight cases necessitating hip arthroplasty. Of eight surviving patients with trochanteric fractures, serious complications developed in two: non-union in one and septicaemia in one, necessitating nail extraction 1 week after the primary operation. The complication rate was higher than in an unselected femoral neck fracture material.