The histological appearances of late segmental collapse of the femoral head after transcervical fracture.

A third of severely displaced femoral neck fractures fail to unite, and of those in which sound bony union occurs, no fewer than 28 per cent later develop collapse of the upper, weight-bearing segment of the femoral head (Brown and Abrami 1964). Although the features ofthis condition have already been described by Santos (1930), Sherman and Phemister (1947), Phemister (1934, 1940, 1949), Coleman and Compere (1961) and Hulth (1961) amongst others, continuing controversy about the interpretation of the microscopic findings has encouraged me to present the findings in twelve patients. Histological sections and slab radiographs of serial coronal blocks of the excised femoral heads were prepared as described elsewhere in this issue of the Journal. Unfortunately it was impossible to remove the femoral head in one piece from two patients. Previous serial radiographs were examined except those of Case 3 which had been lost.