1. A study of all the cases of hip fracture seen at time Massachusetts General Hospital since 1920 revealed five cases of spontaneous fracture of the neck of the femur through the site of the epiphyseal line in adults. Three of these patients were known tabetics. Recognition of the fracture in another case led to a diagnosis of latent syphilis. A similar fracture was seen in only one other condition,-namely, radiation osteonecrosis.
2. The condition is recognized by four diagnostic criteria: (1) a break through the epiphyseal region between the femoral head and neck; (2) flocculent areas of calcification in the soft tissues surrounding the hip joint; (3) an apparent increased density of the femoral head; and (4) a history of little or no trauma to account for the fracture.
3. In view of the pathology and clinical aspects of these cases, one is justified in suspecting tabes when this fracture occurs.
(C) 1940 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.